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Service Advocate – Medicare Member Support – Work From Home (Remote)

Work from home Full-time role Hiring

Join arenaflex: Transforming Healthcare Through Compassionate Member Support Are you ready to make a meaningful difference in the lives of others while building a rewarding career in healthcare? At arenaflex, we believe that healthcare should be personal, convenient, and affordable for everyone. We're on a mission to deliver human-centered healthcare solutions that improve the wellbeing of millions of Americans, and we need passionate individuals like you to help us achieve this goal. As a leading healthcare company committed to innovation and compassionate care, arenaflex is looking for a dedicated Service Advocate to join our Health Results Team. This is not just a job—it's an opportunity to be part of something bigger. You'll be the voice that members hear when they need guidance, the advocate who helps them navigate their healthcare benefits, and the compassionate listener who empowers them to make better health decisions. Position Overview The Service Advocate within the Health Results Team serves as a critical link between arenaflex and our Medicare members. You'll engage with members through multiple channels including phone and digital platforms, conducting outreach initiatives designed to motivate and encourage healthy behaviors through innovative, compassionate, and empathetic communications. Your primary objective will be ensuring that every member has a clear understanding of their available Medicare benefits, particularly those related to essential screenings and medications. This role involves both inbound and outbound member communications, where you'll serve as a single point of contact to resolve inquiries, provide accurate information, and connect members with the resources they need to achieve optimal health outcomes.

Key Responsibilities

  • Member Communication: Conduct inbound and outbound calls to members who may benefit from assigned services including healthcare visits, screenings, vaccinations, or medication refills
  • Barrier Identification: Effectively capture barriers and collect data while using motivational speaking skills to provide solutions that help close gaps in care
  • Exceptional Support: Deliver top-tier support to every member, ensuring all inquiries are professionally addressed, triaged, and resolved appropriately
  • Care Coordination: Act as a liaison between members, health plans, physicians, and pharmacies to ensure seamless coordination of care
  • Data Collection: Actively listen and collect member-reported data elements in the CRM system to support clinical record chasing for HEDIS documentation
  • Information Delivery: Provide members with the right information at the right time to help them make better decisions about their health and healthcare
  • Member Education: Engage, counsel, and educate members based on their unique needs, preferences, and understanding of available services
  • End-to-End Ownership: Take complete accountability for the member experience and deliver exceptional support throughout their journey
  • Issue Resolution: Respond to questions and resolve issues as a "single point of contact," escalating to leadership as appropriate
  • Relationship Building: Build trusting relationships with members by taking responsibility to understand their needs completely
  • Program Guidance: Walk members through available programs, arenaflex tools, and resources to support healthcare behaviors
  • Documentation: Report and track all member contacts, events, and outcomes through appropriate systems and processes
  • Professional Communication: Use professional interpersonal skills to build relationships with both internal and external members/constituents
  • Business Communications: Utilize system tools and resources to produce quality business communications including letters and spreadsheets in response to inquiries
  • Multi-Function Performance: Handle multiple functions and products while maintaining and exceeding performance standards
  • Continuous Improvement: Identify issues that need escalation and provide suggestions for resolution
  • Brand Representation: Demonstrate professionalism and present a positive image of the company while engaging with members

Required Qualifications

Experience:

  • Recent and related experience working with HEDIS screening measures and behavior change
  • Related experience working directly with members/consumers—preferably in a call center setting
  • Minimum of 2 years of current and related experience within healthc

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