Experienced Health Advocate - Medicare Member Services & HEDIS Quality Initiatives (Work From Home)

Join arenaflex: Where Heart Meets Healthcare Innovation

Are you passionate about making a meaningful difference in people's lives? Do you thrive in a fast-paced, customer-focused environment where your communication skills can truly impact health outcomes? Welcome to arenaflex – a leader in transforming healthcare delivery across the nation. At arenaflex, we believe that healthcare should be personal, convenient, and affordable for everyone. Our mission is simple yet profound: carrying our heart to every moment of your health. This purpose drives everything we do, from the way we interact with our members to how we develop innovative solutions for a constantly evolving healthcare landscape.

When you join arenaflex, you become part of a team that is empowered to change lives. Our Heart At Work Behaviors™ guide our culture – we encourage every team member to feel ownership over their role in transforming how healthcare is delivered. We are currently seeking a dedicated and compassionate Health Advocate to join our Solid Results Group. This is not just another call center job; it's an opportunity to be a trusted voice for Medicare members, helping them navigate their healthcare benefits and achieve better health outcomes.

If you have a background in healthcare, excellent communication skills, and a genuine desire to help others, we invite you to explore this exciting opportunity. This is a full-time, work-from-home position that offers competitive compensation, comprehensive benefits, and the chance to grow your career with an industry leader.

Position Overview: Health Advocate - Medicare Member Services

As a Health Advocate within our Solid Results Group at arenaflex, you will play a pivotal role in our mission to deliver human-driven healthcare that makes a real difference in people's lives. You will interact with Medicare members through multiple channels – primarily telephone and digital platforms – to encourage and motivate healthy behaviors through innovative, compassionate, and empathetic communications.

The core objective of your outreach efforts will be to ensure that every member has a clear understanding of the benefits available to them under their Medicare plan, specifically regarding preventive screenings, medications, and other essential health services. You will serve as a vital bridge between healthcare providers, health plans, and our members, ensuring that no one falls through the cracks when it comes to receiving the care they deserve.

Key Responsibilities

Your day-to-day responsibilities as a Health Advocate will be diverse and meaningful. Here's what you can expect:

• Member Outreach: Conduct inbound and outbound calls to Medicare members who may benefit from specific healthcare services, including health visits, screenings, vaccinations, and prescription refills. Your goal is to close gaps in care and ensure members receive timely preventive services.
• Barrier Identification: Effectively capture and document barriers that prevent members from accessing care. Use motivational interviewing techniques to provide solutions and facilitate improved health outcomes.
• Exceptional Customer Service: Treat every member with professionalism, respect, and dignity. Ensure all questions are thoroughly addressed or appropriately triaged and escalated when necessary.
• Care Coordination: Act as a resource for members and assist in coordinating care between health plans, physicians, and pharmacies. Be the advocate they need to navigate the complex healthcare system.
• Clinical Documentation: Actively listen and collect member-reported data elements in our CRM system to support clinical record chasing for HEDIS (Healthcare Effectiveness Data and Information Set) clinical record documentation of services rendered.
• Education and Guidance: Provide members with the right information at the right time to help them make better decisions about their health and healthcare. Improve member experience, retention, and growth by efficiently delivering coordination services.
• Personalized Support: Engage, counsel, and educate members based on their unique needs, preferences, and understanding of available services. Take end-to-end accountability for the member experience.
• Issue Resolution: Respond to questions and resolve issues as a "single point of contact," escalating to leadership as needed. Take ownership of member-assigned cases to resolve their problems and connect them with additional services when appropriate.
• Relationship Building: Build trusting relationships with members by taking responsibility to understand their needs completely. Walk them through programs, arenaflex tools, and resources that support healthcare behaviors.
• Documentation and Tracking: Report and track all member contacts, events, and outcomes through appropriate systems and processes. Maintain accurate records of all interactions.
• Professional Communication: Use professional interpersonal skills to build relationships with both internal and external members/constituents. Utilize system tools and resources to produce quality business communications, including letters and spreadsheets.
• Multi-Tasking Excellence: Handle multiple functions and products while maintaining and exceeding performance standards. Identify issues that need escalation and provide suggestions for resolution.
• Professional Representation: Demonstrate professionalism and present a positive image of the organization while engaging with members and constituents. Support individual, team, and business goals and initiatives.

Essential Qualifications

To succeed in this role, you must possess the following qualifications:

• Experience: Minimum of 2-4 years of experience in a healthcare setting with direct communication with various levels of management, including clinical providers. Previous experience working with HEDIS screening measures and behavior change initiatives is highly valued.
• Member Interaction: Related experience working directly with members/consumers – preferably in a call center setting. You should be comfortable handling high-volume calls while maintaining quality and empathy.
• Healthcare Background: 2-4 years of experience in healthcare, healthcare marketing, outreach, health education, health coaching, or disease management.
• Technical Skills: Windows-based application knowledge with the ability to use standard corporate software packages and corporate applications. A high level of computer literacy is essential.
• Communication Skills: Strong verbal and written communication skills, with experience speaking with clinical providers and clinical staff. Excellent active listening skills.
• Interpersonal Abilities: Strong interpersonal skills with the ability to develop and maintain effective working relationships. Demonstrated ability to de-escalate situations with empathy and patience.
• Analytical Thinking: Strong analytical skills focusing on accuracy and meticulousness. Ability to identify problems and propose effective solutions.
• Personal Attributes: Demonstrated empathy, curiosity, enthusiasm for learning, compassion, and strong listening skills. A genuine desire to advocate for members.
• Adaptability: Ability to thrive with change and adapt to different focuses in short amounts of time. Comfortable working independently and applying critical thinking skills when needed.
• Multi-Tasking: Ability to perform multiple tasks, prioritize effectively, and adapt to a fast-paced, changing environment. Must be organized and detail-oriented.
• Decision Making: Ability to make effective and independent decisions. Capacity to resolve complex issues with responsiveness and caution.
• Education: High School Diploma or G.E.D. required. A Bachelor's degree is preferred but not required.
• Language Skills: Bilingual or multilingual candidates are strongly preferred.
• Certifications: Clinical certification (certified nursing assistant, clinical assistant, etc.) is strongly recommended but not required.

Why Join arenaflex?

At arenaflex, we know that our greatest asset is our people. That's why we offer a comprehensive benefits package designed to support your health, wealth, and well-being:

• Competitive Compensation: We offer competitive pay ranges that reflect your experience, education, and geographic location. The typical pay range for this position is competitive within the industry.
• Health Benefits: Enjoy comprehensive medical, dental, and vision coverage. We believe in taking care of your health so you can take care of our members.
• Retirement Savings: Eligible employees can enroll in our 401(k) retirement savings plan with company match. Plan for your future with our robust retirement options.
• Stock Purchase Plan: Qualified employees can participate in our Employee Stock Purchase Plan, allowing you to invest in the company's growth.
• Life Insurance and Disability: We provide fully paid term life insurance for qualified employees, as well as short-term and long-term disability benefits.
• Wellness Programs: Take advantage of numerous wellness programs, educational assistance, free development courses, and a arenaflex store discount program with participating partners.
• Paid Time Off: Enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. We believe in work-life balance and giving you the time you need to recharge.
• Career Development: Access to free development courses and opportunities to grow your career within the organization.

Work Environment and Culture

This is a work-from-home position, giving you the flexibility to work in a comfortable environment while still being part of a collaborative team. At arenaflex, we embrace flexibility and understand the importance of balancing work with personal life. You'll have access to the tools and resources you need to succeed from your home office, including comprehensive training and ongoing support from our leadership team.

Our culture is built on the foundation of empathy, innovation, and accountability. We encourage creative problem-solving and value employees who are passionate about making a difference. When you represent arenaflex, you're not just representing a company – you're representing a commitment to transforming healthcare and improving lives.

Career Growth Opportunities

At arenaflex, we believe in investing in our employees' futures. This position offers excellent opportunities for career advancement within the healthcare industry. As you gain experience and demonstrate your capabilities, you'll have access to additional responsibilities, leadership roles, and specialized positions within the organization. We support internal mobility and encourage our team members to explore different areas of our business.

Whether you're looking to deepen your expertise in member services, move into management, or transition into other areas of healthcare operations, arenaflex provides the resources and support to help you achieve your career goals.

Ready to Make a Difference?

If you're ready to join a team that truly cares about making healthcare more personal, convenient, and affordable, we encourage you to apply for this exciting opportunity. At arenaflex, you'll find more than just a job – you'll find a career where your work matters and your voice matters.

We are looking for compassionate, driven individuals who are ready to embody our mission of carrying heart to every moment of health. If you have the skills, experience, and passion to excel in this role, we want to hear from you.

How to Apply:

All eligible candidates can apply for this position by following these steps:

1. Read the official notification carefully from our official website.
2. Fill out the application form completely and accurately.
3. Attach the required documents, including your qualifications certificate with mark sheets, passport-sized photographs, and your signature.
4. Submit your application.

arenaflex is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applications from all qualified individuals regardless of race, color, religion, sex, national origin, age, disability, or any other protected characteristic.

Note: arenaflex requires certain employees to be fully vaccinated against COVID-19 (including any booster shots if required), unless approved for a reasonable accommodation based on disability, illness, religious belief, or other legally recognized reasons. You must have received at least one COVID-19 shot before your first day of work and provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your work.

Join us at arenaflex, where your heart for helping others meets your career aspirations. Apply today and become part of a team that's changing healthcare for the better!