Member Relations Specialist

This position will serve as the primary contact and resource for senior LOB members who have been selected part of the member liaison program. The individual will conduct outbound telephone calls to welcome and educate new senior members to Regal/Lakeside/ADOC and conduct a full welcome call by assisting with any onboarding or transitional needs. Metrics are set for volume of welcome calls and volume of RSVPs to the new member orientation- as well as member orientation attendance with a focus on not just quantity RSVPs but quality. Position will be fully cross trained in Member Relations responsibilities including Welcome calls, courtesy calls and Member orientation invites/attendance. The individual will be responsible for providing a higher level of assistance, guidance, and customer service support to not only the new senior LOB members but the full existing senior LOB membership assigned to the selected PCPs part of the member liaison program The MR team conducts "Welcome Calls" to North AND South Regal, Lakeside and ADOC CMC, Medi-Medi and Senior members to welcome the new members to our IPA/Medical Group, assists members with continuity of care (appointments, authorizations, etc.) and highlights member benefits and services. They are responsible for member orientation invites and RSPVs for both North and South and have attendance goals. This position also conducts "Courtesy Calls" to the same members at 6 months and 12th months post enrollment to ensure continued member satisfaction and retention. Welcome calls are especially important to reach the new member quickly to ensure a greater ease in transition of a new medical group. Obtaining RSVPs to the new member orientation is an important responsibility of the team and they have RSVP and attendance goals. In addition, this team is responsible for assisting members transferring into the new member Orientation and conducting reminder calls. There are Ongoing programs such as the Member Liaison program and Age in program in which the team is responsible answering the queues and conducting outbound calls. All with the overall goal of company senior retention.
Essential Duties and Responsibilities include the following:
• Serve as the primary contact and resource for the new and existing senior LOB members assigned to the member liaison program
• Keeping a good relationship with the PCPs and office managers assigned to the member liaison program
• Conduct a minimum of 65 outbound calls per day (as applicable and not limited to this volume) welcome call and courtesy calls.
• Educate current members of their assigned member liaison for all customer service needs and inquiries.
• Assist with continued duties such a member orientation reminder calls, transfer in calls and any follow up no show calls.
• Act as a dedicated Regal rep for the assigned PCP member liaison office for their senior members.
• Discuss the value added programs/services members are currently receiving through Regal
• Effectively communicate with members as well as other internal staff
• Liaise with external business partners and internal departments.
• Coordinate and collaborate on assignments and projects.
• Successfully manage multiple assignments and projects within specified timelines.
• Report assignment and project statuses and results to management.
• Accurately document call results in Microsoft Excel.
• Own overall satisfaction, retention, and success of members
• Duties and responsibilities will increase with experience.
The pay range for this position at commencement of employment is expected to be between $ 22 /hour to $25/hour ; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:
- Employer-paid comprehensive medical, pharmacy, and dental for employees
- Vision insurance
- Zero co-payments for employed physician office visits
- Flexible Spending Account (FSA)
- Employer-Paid Life Insurance
- Employee Assistance Program (EAP)
- Behavioral Health Services
Savings and Retirement:
- 401k Retirement Savings Plan
- Income Protection Insurance
Other Benefits:
- Vacation Time
- Company celebrations
- Employee Assistance Program
- Employee Referral Bonus
- Tuition Reimbursement
- License Renewal CEU Cost Reimbursement Program
- Business-casual working environment
- Sick days
- Paid holidays
- Mileage
• High School Diploma or equivalent required. College Degree preferred.
• Minimum of 2 years of experience at a Health Plan or IPA/Medical Group required.
• Minimum of 2 years experience in a fast-paced call center environment required.
• Prior experience in member retention or sales preferred.
• Strong customer service skills.
• Must have excellent telephone etiquette and effective oral communication skills.
• Excellent presentation and interpersonal skills.
• Proficient in Microsoft Office. Must know how to create appointments/meetings in Microsoft Outlook, navigate and document in Microsoft Excel, create presentations in Microsoft PowerPoint, and generate documents in Microsoft Word.
• Analytical and attention to detail skills.
• Bilingual (English & Spanish) fluent.
• Strong time management, organizational, and prioritization skills.
• Ability to manage multiple assignments and projects meeting deadlines.
• Ability to type 45 WPM accurately.
• Ability to work independently with minimal supervision.
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