Customer Success Specialist I

Position Overview:
The Customer Success Specialist I is responsible for supportingMetroPlusHealth members and other key stakeholders across the customer's journey. They are expert on the system and understand the NYSOH processes to quickly route members to the appropriate resolution and support.

The Customer Success Specialist I works as a liaison to ensure proper processes are introduced and implemented such that the MetroPlusHealth experience is enhanced. The Customer Success Specialist I provides excellent customer experience, ultimately resulting in member retention through both inbound and outbound outreach. The Customer Success Specialist I is responsible for overseeing all aspects of member retention and being a single point of contact across all issues that are directed to the Customer Success department.

Scope of Role & Responsibilities

Recertification/renewal of membership
Assist all line of business (Medicaid/Medicare/MLTC/CHP/EP) in retaining current qualified members by following a strategic daily work schedule that includes am and pm hours as well as weekends. This is designed to optimize telephone outreach with members who are due to recertify.
Follow appropriate processes to meet and exceed recertification targets set by the department
Make the recertification process as easy and seamless as possible for our members
Assist members with completion of recertification applications
Partner with different parts of the organization to understand any barriers to the member's experience and work to resolve them appropriately
Meet daily outreach and renewal goals that contribute to overall member retention for the organization
Enrollment and retention support

Assist members with completion of all enrollment activities including but not limited to changing lines of business to ensure member is in the optimal plan, re-enrolling members due to administrative issues, premium payment, etc.
Assist members with PCP selection as well as locating providers and vendors within the Plan's network
Provide end-to-end customer support to drive customer satisfaction and improve customer experience
Interface with internal and external stakeholders to ensure complete resolution
Communicate verbally and in writing with members for all necessary member retention activities
Process improvement

Devise solutions in response to member dissatisfaction/complaints/issues in support of ongoing organizational improvement efforts
Support any ad hoc projects on process improvements
Report common trends identified during member outreach
Other duties as assigned
Required Education, Training & Professional Experience

Associate's Degree and minimum 1 year of experience in direct consumer contact, including, but not limited to, customer engagement, customer services, sales, community engagement.; OR
High school degree and 3-5 years of experience in direct consumer contact, including, but not limited to, customer engagement, customer services, sales, community engagement
Healthcare especially Managed Care experience preferred but not required.
Bi-lingual preferred
Licensure and/or Certification Required

Employees will be required to complete and pass the NY State of Health approved training program and become certified as a Marketplace Facilitated Enroller (MFE)/Certified Application Counselor (CAC). Employees in these positions must also complete all annual recertification requirements and maintain this certification for the duration of their assignment.
Professional Competencies

Functional/Technical skills
Highly organized with attention to detail
Integrity and trust
Customer Experience Focus
Ability to collaborate with different stakeholders
Written and Oral Communication skills
Conflict Resolution
Patience
Problem-solving skills

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