Member Engagement Guide

Company

Highmark Health

This job collaborates with Sales Client Management and the Sales Executive team. The position will develop member transition strategies to steer the transition of members to AHN and community providers; thereby minimizing future member disruption. This position is responsible for educating members about how their insurance benefits work, the financial impact of healthcare choices, available provider/service options and the importance of getting the right care at the right time, in the right place.

The incumbent will play a major role in driving change in member behavior and driving overall business outcomes from a cost of care perspective.

• Empower members to make informed decisions by evaluating the most appropriate type of provider for members' unique needs, assessing which providers are in‑network and ensuring that 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 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.
• Demonstrate business acumen by partnering with the Organization's Sales team and executing proactive sales strategies that influence member buying decisions at enrollment events, focusing on maintaining and increasing enrollment and profitability.
• Participate in the development of sales strategies with the Organization's Sales Team and execute those strategies in sales situations to influence member buying decisions for supplemental coverage, contracts, and profitability for HMIG products along with regional and national dental and vision companies.
• Identify and research operational issues based on member/client feedback and transition details to the appropriate internal department (Product Management, membership, claims, eMarketing, etc.) and seek opportunities for process improvements.
• Drive changes in member behaviors by developing influencing strategies, creating incentive models, and building relationships between executives at the Organization, employers, and community partners.
• Other duties as assigned or requested.

• Bachelor's Degree in Business, Communications, or related field.

• 6 years of related progressive experience in lieu of a Bachelor's degree.

• 3 years of prior sales or client consulting experience, preferably in the Insurance industry.

• None required.
• Producer License in Life, Accident & Health preferred.

• Strong relationship builder across multiple levels of an organization from employee through senior leader.
• Strong communication and influence skills across multiple levels.
• Able to work effectively in a matrix environment.
• Able to juggle competing priorities.
• Strong presentation and written communication skills.
• Strong analytical skills / financial acumen.

0% - 25%

Office-based. Frequent travel to various work sites. Lifting: up to 25 pounds occasionally.

Highmark Health and affiliates prohibit discrimination against qualified individuals based on veteran or disability status and any protected category under applicable law.

The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required.

This job adheres to the ethical and legal standards and behavioral expectations set forth in the code of business conduct and company policies. All employees must comply with HIPAA, privacy policies, and security guidelines.

Minimum: $24.53 | Maximum: $.00