Customer Service Advocate IV - Transforming Healthcare through Exceptional Member Experience and Complex Issue Resolution

Join Oklahoma Complete Health, a Centene company, and be at the forefront of revolutionizing healthcare delivery in Oklahoma Oklahoma Complete Health, a leading Centene company, is dedicated to providing high-quality healthcare solutions that positively impact the lives of our 28 million members nationwide, including Oklahomans. As a Customer Service Advocate IV, you will play a pivotal role in driving member satisfaction by resolving complex issues and concerns, thereby contributing to the transformation of the health of our community. About Us At Oklahoma Complete Health, we pride ourselves on being community advocates and change-makers. Our inclusive culture is built on a foundation of work-life balance, competitive compensation, and continuous career development. We are a collaborative and growing network of innovative thinkers who deliver solutions at the local level, making a tangible difference in the lives of our members. Job Purpose and Key Responsibilities As a Customer Service Advocate IV, you will serve as a champion for our members and providers, leveraging various communication channels to provide timely, accurate, and personalized resolutions to complex complaints and escalations. Your key responsibilities will include: Assessing and researching customer service needs, determining causes, and initiating corrective actions to other service or technical departments as needed. Providing guidance on complex member or provider issues to resolve customer inquiries or requests. Educating members or providers with relevant information and resources to address their complex inquiries or concerns. Delivering exceptional customer service in a fast-paced contact center environment via phone, live chats, and emails. Developing in-depth knowledge and expertise in multiple markets and/or plans, responding to complex or escalated questions. Leading the team in resolving member or provider requests and collaborating inter-departmentally to address inquiries or concerns. Identifying, documenting, and resolving customer information and communications, updating leadership on customer needs through root cause analysis, recommendations, and resolutions. Collaborating with training teams to develop training materials and programs to ensure quality and adherence to policies and procedures. Recording all activities for quality and metrics reporting through our Customer Relationship Management (CRM) application. Adhering to quality standards, regulations, and confidentiality across various communication channels. Participating in special projects as needed and performing other duties as assigned. Essential and Preferred Qualifications To excel as a Customer Service Advocate IV, you will need: A High School diploma or GED. 4+ years of related experience in customer service, preferably in a healthcare or complex issue resolution environment. Vocational or technical education may be required in addition to prior work experience, with potential additional on-the-job training or continuous learning education. Residency in Oklahoma is mandatory. Preferred qualifications include: Prior experience in a contact center environment, handling complex customer inquiries or escalations. Knowledge of healthcare operations, plans, and regulations. Excellent communication and interpersonal skills. Ability to work in a fast-paced environment, prioritizing multiple tasks and adapting to changing situations. Skills and Competencies To succeed in this role, you will need to possess: Exceptional customer service skills, with the ability to empathize and resolve complex issues. Strong analytical and problem-solving skills, with the ability to identify root causes and develop effective solutions. Excellent communication and interpersonal skills, with the ability to collaborate with various stakeholders. Proficiency in CRM applications and other customer service software. Ability to work in a team environment, leading and supporting colleagues as needed. Career Growth Opportunities and Learning Benefits At Oklahoma Complete Health, we are committed to your growth and development. As a Customer Service Advocate IV, you will have opportunities to: Develop in-depth knowledge and expertise in multiple markets and/or plans. Enhance your analytical and problem-solving skills through complex issue resolution. Improve your communication and interpersonal skills through interactions with members, providers, and internal stakeholders. Participate in training and development programs to stay up-to-date on industry trends and best practices. Work Environment and Company Culture We pride ourselves on our inclusive culture, which values work-life balance, competitive compensation, and continuous career development. As a Centene company, we offer a comprehensive benefits package, including: Competitive pay. Health insurance. 401K and stock purchase plans. Tuition reimbursement. Paid time off and holidays. A flexible approach to work, with remote, hybrid, field, or office work schedules available. Our pay range for this role is $21.64 - $36.53 per hour, with actual pay adjusted based on your skills, experience, education, and other job-related factors. Join Our Team and Make a Difference If you are a motivated and compassionate professional looking to make a positive impact on the lives of our members, we encourage you to apply for this exciting opportunity. At Oklahoma Complete Health, we are committed to diversity and value the unique perspectives and experiences that you bring to our team. As an equal opportunity employer, we welcome applications from qualified candidates without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Take the first step towards a rewarding career with Oklahoma Complete Health. Apply now and join our team of dedicated professionals who are transforming healthcare delivery in Oklahoma.