Job Description

Administrative/ Clerical

Steward Health Care Network

Steward Direct

Req Number:

Job Details:

The Disenrollment Navigator acts as a member consultant and resource to health plan members with a goal of retaining eligibility with Steward Health Choice. The Disenrollment Navigator provides customer service for members, including connecting with resources for completing all necessary renewal paperwork to maintain eligibility, outreach to at-risk members, answering phones, and meeting monthly goals.

Place outreach phone calls in a professional tone and appropriately respond to member inquires or requests while maintaining performance measures:
  • Average 80+ calls per day to meet contact goal(s)
  • Connect members with appropriate resources to assist with eligibility renewal
  • Use appropriate closing (brands call)
Completes required documentation. Completes follow-up paperwork and duties necessary to meet or exceed the caller's expectations. Document calls on note screen of medical management software system.

Assist leadership in identifying key improvements that will provide the optimum benefit in enhancing retention and patient satisfaction. Lead and facilitate improvement with member engagement and within Member Services team that will drive or have a direct impact on member retention and enhancing patient satisfaction. Develop effective communication methods with membership, SHCN team members, and leadership. Work collaboratively to solve problems and minimize barriers. Collaborate across functional departments to manage and implement member engagement strategies. Identifies and facilities the collection and analyzing of quantitative and qualitative data and identifies key findings. Present relevant presentations to various stakeholders across the network. Participates in the development and management of the department, including training, mentoring, recruiting, and other departmental activities.

High School diploma / GED

Bachelor's degree in related field or an equivalent combination of education and years of experience required

One (1) or more years of experience in a call center environment

One (1) or more years of customer service experience

Understanding of the health care delivery setting

Experience with diverse populations a plus

Proper customer service techniques

Must possess the ability to present and explain complex material to member populations in a professional manner

Proven administrative and coaching ability in complex environments

Strong ability to analyze, interpret, and evaluate data resulting in actionable recommendations

Excellent presentation and organizational skills; excellent verbal and written communication skills

Must have strong problem solving ability

Ability to prioritize and manage multiple projects and demanding workloads

Must be able to work in a team environment with good communication skills, supportive attitude, and the ability to provide mentorship when appropriate

Lean or Six Sigma training a plus; knowledge of process improvement techniques required

Knowledge of managed care principles and health plans

MS Office Suite

Demonstrated proficiency preparing spreadsheets, graphs, and other presentation materials

Application Instructions

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