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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