Job Abstract

At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Member Services Operations Consultant is responsible for coordinating communications with members, resolving member inquiries and problems, and meeting member service requirements as required in this Agreement. The primary goal of this role is to ensure a high level of member satisfaction and engagement by incorporating member perspectives and feedback into the organization's improvement initiatives and member services.

If you are located in the state of Ohio, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Coordinate communications with members, including responding to inquiries and resolving member problems in a timely and effective manner
• Ensure that members impacted by population health initiatives, such as quality improvement projects, are included on the project team to identify member perceived barriers and assist with the design and testing of interventions impacting members
• Incorporate member perspectives and feedback into evaluations of improvement initiative success
• Ensure that pertinent knowledge obtained through the organization's population health improvement initiatives is incorporated into member services
• Collaborate with national resources to develop an annual marketing plan that aligns with the organization's goals and objectives
• Serve as the primary contact with the Ohio Department of Medicaid for member marketing and communication matters
• Oversee member complaints, including state complaints, to ensure compliance with rules and regulations, and efficiently and effectively resolve matters. Coordinate resolution for high need cases as they arise
• Manage the review process for Ohio member communications to ensure accuracy and adherence to guidelines
• Arrange and run member advisory committee meetings in alignment with rules and regulations, including tracking and ordering of quarterly meeting invitations, gift cards, member inquiries, and completion of required reporting in a timely and accurate manner
• Arrange and oversee local member events in line with the marketing plan and local needs
• Monitor and initiate changes to the Ohio members' public website to ensure it provides accurate and relevant information to members
• Serve as the plan contact for the MyUHC.com member portal, ensuring the portal is accurately and effectively meeting member needs
  

Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+years of experience in member services, call center, customer relationship management, and/ or healthcare marketing
• 2+ years of project management experience
• Ohio Life and Health Insurance License (or obtain within 6 months)
• Intermediate+ level proficiency in Microsoft Office Suite (Word, Excel, Outlook)
• Proficiency with Salesforce (Customer Relationship Management) software
• Proven excellent communication and interpersonal skills
• Proven ability to effectively resolve member complaints and escalate issues as needed
• Proven solid organizational and problem-solving abilities
• Ability to travel up to 25% locally

Preferred Qualifications:

• 3+ years of experience in member services/ call center environment
• 2+ years account management experience
• 2+ years marketing experience
• Solid knowledge of population health initiatives and their impact on member services
• Familiarity with Medicaid and Medicare rules and regulations
• Familiar with ChatGPT/365 CoPilot
  

Note: This job description is a general outline of the key responsibilities and qualifications of the Member Services Operations Consultant role. Additional duties may be assigned as necessary to meet the organization's needs.

*All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.