Quality Retention Specialist
Job Summary
Supporting member disenrollment requests, the full-time remote Quality Retention Specialist, fluent in Chinese or Mandarin, will manage escalated calls, identify process improvements, and collaborate with various departments to enhance the member experience.
Key responsibilities
- Serve as a subject matter expert in handling escalated member calls at risk of disenrollment
- Identify and recommend process improvements within the Member Engagement department
- Conduct outbound and inbound calls, adapting to members' communication preferences and ensuring timely support
Required qualifications
- 1+ year of healthcare experience
- 1+ year of experience 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
- Solid knowledge of Medicare Managed Care Manual Chapter 2 and related guidelines
- Ability to communicate effectively and troubleshoot member issues
Complete Job Description
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