Quality Retention Specialist

Job Summary

Supporting member disenrollment requests, the full-time Quality Retention Specialist will manage escalated calls, identify process improvements, and ensure compliance while working remotely and adhering to PST hours.

Key responsibilities

• Serve as a subject matter expert for escalated member calls and resolve issues related to disenrollment
• Identify and implement process improvement opportunities within the Member Engagement department
• Conduct timely outbound and inbound calls, adapting to members' communication preferences

Required qualifications

• 1+ year of healthcare experience and familiarity with Medi-Cal, Commercial, and Medicare Managed Care Plans
• High School Diploma or GED; Bachelor's degree or four years of additional experience in lieu of education preferred
• Solid knowledge of Medicare Managed Care Manual and related guidelines
• Effective problem-solving and organizational skills in a fast-paced environment
• Bilingual skills in Spanish, Vietnamese, Mandarin, Cantonese, or Korean preferred