Job Description

Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not-for-profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,800 dedicated employees throughout its Phoenix, Tucson, Chandler and Flagstaff offices. Providing health insurance products, services and networks to more than 1 million Arizonans, Blue Cross Blue Shield of Arizona offers various health plans for individuals, families, and small and large businesses. Blue Cross Blue Shield of Arizona also offers Medicare supplement plans to individuals over age 65.

Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

Purpose of the Job
This position is responsible for researching, developing and executing community initiatives to ensure prospect and member engagement.  This position is also responsible for the sale of the Medicare products to qualified Medicare beneficiaries throughout the state of Arizona as needed.  This role is highly accountable to ensure member satisfaction with health plan services and to prevent disenrollment due to dissatisfaction. This position will require proactive member/community facing events, and relies heavily on membership retention. Innovative ideas and attention to details are critical for achieving the department’s goals and objectives.
Essential Job Functions & Responsibilities
• Actively demonstrate superior customer service to all internal and external contacts
• Implement a robust Member Advisory Council program and assist with development of, preparation for and facilitation of the meetings.
• Identify and create opportunities for general member retention activities, such as educational meetings and social events.
• Collect, monitor and analyze data via call logs and other reports to proactively identify members who may be experiencing dissatisfaction with the health plan services and benefits for outreach/intervention.
• Able to respond and troubleshoot with accuracy to pharmacy, benefits, eligibility and claims related questions or concerns for the Medicare line of business. Maintain working knowledge of Medicare while adhering to health plan policies and procedures.
• Work with Member Services, Grievance and Appeals, Compliance, Care Management and other Departments to identify and outreach to members who are at risk for dissatisfaction and disenrollment.
• Serve as a connection to members and their families experiencing difficult, complex or chronic unresolved problems with the health plan benefits and services. Work to bring the member and their family whole and satisfied with services.
• Work with member complaints and concerns that are identified through CTM and other member touch points.
• Work cross-functionally with internal and external teams to ensure retention program outcomes and member satisfaction goals are met.
• Conduct outbound call campaigns, surveys and other member focused interventions utilizing outbound call scripts and talking points.
• Assist with quality improvement projects focusing on the member experience.
• Attend new member orientations to keep abreast of member education of the health plan benefits and programs.
• Read and respond to department communications, actively participates in staff meetings and department activities that include process improvements or team building.
• Maintain production levels as set by departmental goals.
• The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
• Perform all other duties as assigned.

 

BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Skills / Requirements

QUALIFICATIONS

Required Qualifications
1. Required Work Experience
• 3 years in Medicare Sales, Customer Service and Health Plan Operations.
2. Required Education
• High-School Diploma or GED in general field of study.
3. Required Licenses
• Active Arizona (a state in the United States) Department of Insurance Health & Life Producer’s License.
• Possess a valid Arizona Driver’s License with no restrictions or unfavorable history
4. Required Certifications
• N/A


Preferred Qualifications
1. Preferred Work Experience
• Medicare Advantage Health Plan experience.
2. Preferred Education
• Bachelor’s Degree in general field of study
3. Preferred Licenses
• AZ Health Insurance License.
4. Preferred Certifications
• N/A

COMPETENCIES

Required Competencies
1. Required Job Skills
• N/A
2. Required Professional Competencies
• Independent decision-making ability
• Displays Sound Judgment
• Member Focused
• Member Service
• Verbal Communication
• Informing Others
• Process Improvement
• Complex Problem Solving
• People Skills
3. Required Leadership Experience and Competencies
• Teamwork, People Management, Managing Processes, Emphasizing Excellence, Meeting management skills


Preferred Competencies
1. Preferred Job Skills
• N/A
2. Preferred Professional Competencies
• N/A

3. Preferred Leadership Experience and Competencies
• N/A

Application Instructions

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