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Business Consultant, Member Experience Operations

Primary Location: Santa Ana, CA
Additional Locations: CA-Santa Ana
Medicare Member Experience is a innovative role in the Medicare Service Operations department. We are looking for a candidate in the local Southern CA market to serve as a champion and manage Medicare Member Experience suite of initiatives to support growth and retention goals. Involved in initiative planning and implementation, ongoing vendor relationship management and satisfaction for assigned initiatives that impact the delivery of products and services to the internal and external environment (See Family Summary). Collaborates with external vendors, and internal teams, primarily in the Customer Service department, consulting team members and/or matrixed staff as required in support of initiatives. Accountable for transferring knowledge, best practices (external and internal), methodology and tools to client organizations. Participates as a team member, will be responsible for concurrent initiatives or act as team lead for less complex projects based on resource requirements.

Fundamental Components:
Supports holistic solutions and/or key strategic plans. Will be accountable for leading select aspects of successful implementation of member and provider experience programs. Proactively identifies opportunities for improvement within assigned initiatives. Participates in influencing cross functional departments and builds optimal member experience for retention and positive results. Participates and supports metrics integration and communications for optimal results such as member materials and communications. Shares joint accountability for initiative’s and collaborates with sales on member meetings. Participates in initiative planning as required. Supports engagement using a disciplined repeatable methodology Designs, develops interventions and facilitates weekly work sessions. Will support or lead member multi-cultural initiatives and will manage pilot programs at local market level. Candidate is demonstrates skills in accessing technology and tools available to document and track outcomes. Develops and implements outreach strategies to Medicare members and providers as needed.

Background Experience:
Experience with moderate scale initiatives. 5+ years experience with one or more of the following methodologies: Medicare and Medicaid management, project planning, strategic business planning, and excellent presentation skills. Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously. Ability to work independently, honors commitments and collaborates with teams to create best in class member experience. Demonstrated integrity with relevant initiatives: strong project management and organizational skills/experience. Operational experience in a relevant discipline. Masters degree preferred, but not required. College degree. Appropriate sales licensure and bilingual preferred.

Additional Job Information:
Team building skills is critical to engage and communicate with various departments within the organization. Strong project management skills. Ability to develop mutually beneficial working relationship with various internal teams by operationalizing member experience initiatives. Strong background in Medicare, Compliance knowledge who can act as the voice of the customer. Organizational skills is a must in a fast paced department. Time management skills. Critical thinking skills. Oral, presentation and written communication skills. Candidate will work with Stars, Member Service and Sales teams to meet member experience, retention and growth goals.

Required Skills:
General Business - Communicating for Impact, Leadership - Collaborating for Results, Service - Creating a Differentiated Service Experience

Desired Skills:
Benefits Management - Maximizing Healthcare Quality, Leadership - Driving a Culture of Compliance, Sales - Knowing Customers

Functional Skills:
Communication - Communication Delivery - Public Speaking, Customer Service - Customer Service - Member Services - HMO products, Management - Management - Medicare, Management - Management - Operations, Project Management - Cross-functional project management

Potential Telework Position:

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.


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