Member Advocacy Team Specialist I

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/

How YOU will make a Difference:

A Member Advocacy Team Specialist is primarily the first point of contact on the Helpline and actively works both less complicated and more complicated calls, escalations and cases. This individual is responsible for providing superior internal and external customer care support, coaching, and directing Customer Care Advocates on call handling best practices to ensure timely resolution to keep Customer Care Advocates on the phones and is delivered in a caring and professional manner consistent with the Member Advocacy Team standards. Additionally, this position provides support related to Helpline calls that require further research or that are more complex in nature, triaging, acknowledging, and assigning Member Advocacy Team emails and CRM Tasks, processing Protected Health Information (PHI), Confidential Communication, Coordination of Benefits (COB) outreach, and other duties as assigned. This individual maybe asked to provide support to the Employer/Broker Team as well as take member and provider calls when needed. The Member Advocacy Team Specialist II is also responsible for proactively participating in identifying training opportunities, system tools that Customer Care Advocates may need, and trends that drive higher Helpline calls. This individual will actively communicate training opportunities and trends to the Customer Care Management team.

What YOU will do:

• Adhere to established Service Level Agreements for the Helpline and all new and ongoing open work items.
• Provides superior frontline internal and external support to Customer Care Advocates and Care Management staff.

Advocates for Customer Care Advocates by proactively engaging with other Member Advocacy Team members to handle requests that involve additional research and resolution and will ensure issues are completed efficiently and expeditiously.

• Models the right behaviors to positively guide and influence Customer Care Advocates and Care Management staff.
• Work closely with the management team to stay updated on service knowledge and stay informed of any changes in department/company policies.
• Share recommendations to the Continuous Process Improvement (CPI) team to strengthen the process for preventive measures.
• Part of “Flexforce” team and is cross-trained/cross-utilized with Employer/Broker Support Team and Member Advocacy Team’s Escalation Team.
• Advocate for callers by working with internal and external stakeholder to efficiently and expeditiously resolve inquiries, own it, and drive resolution.
• Hold others accountable and report on root cause, corrective, and preventative actions to Customer Care Manager.
• Analyze the request for clarity and engage with submitter for any follow-up information needed to assist in complete resolution of work item.

Own the follow-up process to ensure all elements of the work item are addressed. Partner with other support team(s) when needed for resolution. Provide a complete written resolution to submitter addressing all concerns and steps taken to provide resolution. Work closely with other MAT team members as well as HMA management teams to triage problem-resolution, identify root cause analysis, including corrective and preventative action in order to identify and mitigate risk. Report findings to Manager and greater business as required. Other duties as assigned. High school diploma or equivalent 1-3+ years, providing superior customer service in a call center environment Previous experience working in a medical or healthcare field is preferred Excellent verbal and written communications exemplified through professional, timely, and detailed correspondence Works independently with minimal supervision while maintaining a team-oriented and collaborative approach to problem solving Ability to quickly adjust priorities to respond to pressing demands-and do so with a smile Strong problem solving, project management, business analysis, presentation, and analytical skills Strong interpersonal and communication skills, both written and verbal; comfortable and effective in communicating across all levels of the organization Strong attention to detail and ability to multi-task in a complex, fast-paced environment Knowledge of medical terminology is preferred

Compensation:

The base salary range for this position in the greater Seattle area is $23.55/hr - $27.88/hr for a level I and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level I, we may consider level II for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.

In addition, HMA provides a generous total rewards package for full-time employees that includes:

Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: https://www.accesshma.com/