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Humana Member Advocate Inbound Contact Rep 1, Part-Time in San Antonio, Texas

Description

The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs administrative/operational/customer support/computational tasks. Typically works within a framework of compliance expectations leading to significant variabilities in the inquiries presented by the membership.

Work Environment: This is a customer-centric member advocate environment focused on high quality outcomes versus activities. Our department primarily communicates over the phone, but we are not a 'call center' environment as we are responsible for the member's safety and advocacy outcome as part of the continuum of their care. We value quality work as every action taken in the member services department is to facilitate access to the member and avoid adverse outcomes for the member.

Associates can expect to take anywhere from 12 to 20 inbound calls per day with the focus being on high-quality service with a strong emphasis on member advocacy and patient safety.

While this associate receives inbound calls, with limited up to 60% to 70% of these calls may require associates to place outbound calls to physicians, DME vendors, pharmacies or other entities to coordinate benefits and care for the member.

This role calls for strong emotional intelligence focused on proactively providing solutions, ensuring the member's utmost health and safety. De-escalation skills are a must to thrive in this role. We serve a wide variety of members, some of which are experiencing illness and trauma at the time of their call.

Responsibilities

Work Environment: This is a customer-centric member advocate environment focused on high quality outcomes versus activities. Our department primarily communicates over the phone, but we are not a 'call center' environment as we are responsible for the member's safety and advocacy outcome as part of the continuum of their care. We value quality work as every action taken in the member services department is to facilitate access to the member and avoid adverse outcomes for the member.

  • Associates can expect to take anywhere from 30-35 inbound calls per day with the focus being on high-quality service with a strong emphasis on member advocacy and patient safety.

  • While this associate receives inbound calls, up to 50% of these calls may require associates to place outbound calls to physicians, DME vendors, pharmacies or other entities to coordinate benefits and care for the member.

  • This role calls for strong emotional intelligence focused on proactively providing solutions, ensuring the member's utmost health and safety. De-escalation skills are a must to thrive in this role. We serve a wide variety of members, some of which are experiencing illness and trauma at the time of their call.

Education, Experience, Skill set:

  • High School Diploma or Equivalent

  • 2+ year or more customer service experience within any of the following heavy or high volume health care, call quality, retail, and or anything involving working with an irate customer population or requiring high degree of organization, structure and focus.

  • Ability to communicate general information such as pharmacy; plan medical, dental & vision benefits

  • Excellent verbal and written communication skills

  • Ability to maintain a professional demeanor, practicing strict confidentiality on all platforms for all sensitive information

  • Ability to focus on the training and role without significant interruption during the workday.

  • Strong initiative with the ability to adapt to change as the business requires.

  • Must have the ability and willingness to be selfless and focus on the member as the priority throughout the workday.

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Technology, System, and Platform Knowledge:

Strong computer skills and utilizing multiple systems and applications simultaneously is required. Must be comfortable with gaining new systems knowledge at all times as software is constantly updating requiring the ability to learn systems real time. The following is required to ensure success in the role as a remote work at home associate:

  • Must be proficient in Microsoft Word such as Word, Excel, Outlook/WebEx, Skype and using collaborative platforms for network sharing examples such as SharePoint, and Teams

  • Must have experience using vendor applications examples such as Salesforce, and department CRM Platforms.

Additional Requirements

Must be able to pass the following pre-hire assessments, (Please review in the below additional information):

  • Virtual Job Experience Assessment

  • A writing assignment may be requested during screening and/or interview

  • A language assessment may be performed for English and or bilingual Spanish during screen and/or interview.

Anticipated Start Date/Training Date : 22 February

Hours - Adherence to the following schedule:

  • 20 Hours per week Monday through Friday between the hours of 8:00 AM to 6:00 PM Eastern Time

  • Additional hours may be offered up to 5 hours per week are available as business needs and upon leader approval

  • Shift assignments will be scheduled 4-6 hours daily and must be approved and will be based on business need

Training Hours:

  • 2 to 3 Weeks training

  • Scheduled 8 hours between 8:00 AM to 7:00 PM Eastern Time, Monday through Friday

Location:

  • Remote/Work at Home * Please review Work at Home Guidelines below*

  • United States, excluding Alaska and Hawaii

Language Fluency Requirement

  • English fluency

OR

  • Bilingual English and Spanish fluency

  • The interagency Language Rating, (ILR), test may be requested as required by the Federal Government under the Federal Care Act, to ensure competency.

Preferred Qualifications

  • Associates or Bachelor's Degree

  • Experience in health insurance, Medicare Care Advantage, or compliance industry

  • experience such as in a Physician Medical Office, Clinical Unit/Office Coordination role,

  • Experience and/or background with case management processes

  • Experience with de-escalation of difficult calls

  • Strong documentation and categorization of call type

  • Experience working with geriatric population

  • Member Advocacy Experience

  • Government Compliance experience

  • Additional Information - Please Read Full Details Below

Interview and Remote Work at Home Requirements: - In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring/new hire activities. This position provides an opportunity to work at home.

For Interview Purposes:

  • Access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m,

  • Dedicated secure home workspace for interview or work purposes.

Upon Hire:

  • Must have accessibility to hardwired high speed internet with minimum speeds of 10Mx1M for a home office (Wireless and Satellite are prohibited)

  • Must have a separate room with a locked door that can be used as a home office to ensure you and your members have absolute and continuous privacy during work hours.

  • The following equipment will be provided: laptop, Two Monitors, mouse, keyboard, Avaya phone system that connects to laptop, and modem cable to hard wire connect laptop

  • Humana does not cover reimburse costs to set up a home office, or monthly internet service

Additional Information:

Customer Care Assessment / Virtual Job Experience: After submitting your application, if you are selected to move forward you will receive an email to complete the Virtual Job Experience (VJE). This is an online activity where you will learn more about Customer Care jobs at Humana, try out some of the most common job tasks, and tell us more about yourself.

  • Most people complete the VJE in approximately 30 minutes. To complete it, you will need a smart phone, computer or tablet with internet access, and speakers/headphones.

  • Candidates will not be reviewed for consideration if the VJE, is incomplete.

  • The email will come from vjtadmin@mg.jobtryout.net please add to your contacts or safe senders list to avoid this going to your spam folder.

Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

  • You will be able to respond to the recruiters preferred response method via text, video or voice technologies

  • If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate.

  • You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Continuous New Hire Testing/Assessments: The CarePlus team provides a thorough training program consisting of at least 2 to 3 weeks.

  • Ability to retain and pass multiple exams during new hire training and throughout employment.

Time off Requests:

  • Humana is regulated by the Center for Medicare and Medicaid Services and maintain a high level of commitment to our members. For this reason, time off and scheduling are heavily based on business need so we can provide the best service to our membership.

  • The training and onboarding for this position is critical for your development as an associate. Time off and scheduled obligations during the first 90 days will be evaluated as part of the selection process.

Transfer Timeline within Humana:

  • Interested associates will be eligible to move into a full-time role after successful completion of training, attendance, 6 month's work performance and business availability.

  • Once in a full-time role, must complete a minimum of 2 years within this department before transferring to another department or reverting to part-time role.

Scheduled Weekly Hours

40

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