Consumer Experience Lead

Illinois, United States

Apply with AI Apply

Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must reside in Illinois and be willing to travel within the state. A Bachelor's degree is required, along with over 5 years of experience in call center or service operations, and prior experience with LTSS or program populations. Candidates must also have 3+ years of leadership experience with direct reports, 2+ years of project/program management experience, and knowledge of or experience with Medicaid or DSNP members and grievance/appeals processes. Intermediate to advanced Microsoft Office Suite skills (Word, Excel, PowerPoint, Visio) are necessary, as is the ability to generate innovative strategies, manage multiple priorities, and influence change in a matrixed organization. An MBA is preferred.

Responsibilities

The Consumer Experience Lead will leverage customer insights and data to identify and eliminate friction points, driving improvements in member experience. This role involves advising executives on functional strategies, managing member grievance and appeal trends, and collaborating with various consumer services departments to ensure excellence. Responsibilities include influencing member services activities such as helpline performance, communications, education, website content, and outreach programs. The Lead will also work with other managers to resolve member issues, oversee the interface with the Enrollment Broker, and ensure the delivery of training for member services representatives. Additionally, the role requires ensuring compliance with contract terms for all member services operations.

Skills

Member experience design

Customer service

Grievance and appeal management

Training

Process optimization

Cross-functional collaboration

Communication

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

Land your dream remote job 3x faster with AI

Try Jobo Free