Member Engagement Guide

Job Opportunity At Highmark Health

Job Summary : This position collaborates with Sales Client Management and the Sales Executive team. The role will develop member transition strategies to steer the transition of members to AHN and community providers; thereby minimizing future member disruption. The incumbent will play a major role in driving change in member behavior and driving overall business outcomes from a cost of care perspective.

Essential Responsibilities :

• Empower members to make informed decisions by evaluating the most appropriate type of provider for members' unique needs, assess which providers are in-network and ensure that the members are fully informed of the tools and resources available to transition to AHN or other community providers.
• Advocate for the member by providing assistance with transferring medical records, making prompt appointments with AHN or other community providers and providing assistance with resolving claim or billing issues.
• Educate members about access to comprehensive clinical care and demonstrate the quality of care and advanced outcomes of partner network providers.
• Assist members in engaging medical care from higher quality, more cost effective providers closer to their homes.
• Create new and innovative opportunities for members to interact with patient-focused providers and experience the quality of care first hand for various specialties.
• Demonstrate business acumen by partnering with the Organization's Sales team and executing proactive sales strategies by influencing member buying decisions.
• Identify and research operational issues based on member / client feedback and transition details to the appropriate internal department.
• Drive changes in member behaviors by developing strategies that influence change and create action from benefit executives and individual members.

Education :

Experience :

Licenses or Certifications :

Skills :

Language (Other than English) : None

Travel Requirement : 0% - 25%

Physical, Mental Demands and Working Conditions :

Pay Range : Minimum $24.53 - Maximum $38.00

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.