Sr Specialist, Medicare Member Engagement (Remote)
About the position The Sr. Specialist Member Engagement representative is responsible for monitoring and evaluating member interactions to ensure that the concierge agents adhere to established quality standards. The role involves reviewing call recordings, providing feedback to agents, and collaborating with team leaders to enhance call quality. Responsibilities • Listen to and review Concierge call interactions to assess agent performance against quality standards, including communication skills, adherence to scripts, problem-solving ability, and overall customer service quality. • Deliver constructive feedback to agents and team leaders, highlighting strengths and identifying areas for improvement. • Accurately document evaluation results, creating detailed reports that capture key insights and trends. • Present findings to management and make recommendations for training and development. • Work closely with training teams to develop and implement training programs that address areas of improvement identified during call monitoring. • Ensure that all interactions follow company policies, procedures, and regulatory requirements. • Identify trends in customer interactions and recommend process improvements to enhance overall customer satisfaction and operational efficiency. • Participate in quality assurance calibration sessions with team leaders and management to ensure consistency in evaluation standards. • Keep up to date with industry best practices and emerging trends in quality assurance and customer service. Requirements • High School Diploma or equivalency • 3 years' experience in customer service with a focus on quality assurance or customer service, consumer advocacy, and/or health care systems. • Experience conducting intake, interviews, and/or research of consumer or provider issues. • Excellent written and verbal communication skills to collaborate internally and externally with members, providers, team members, and manager. • Basic understanding of managed healthcare systems and Medicare. Nice-to-haves • Associate or bachelor's degree in social work, Human Services, or related field. • Experience with Medicare and Medicare managed plans such as MAPD, DSNP, and MMP. • Strong problem-solving skills. • Ability to provide constructive feedback in a positive and professional manner. • Detail-oriented with strong organizational skills. • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Teams, Outlook) and quality monitoring tools. • Applications: Genesys, QNIXT, Marx Incomm, WEX. • Bilingual: Spanish /Chinese/ Korean / Vietnamese. Benefits • Competitive benefits and compensation package. Apply tot his job