Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY

The Retention Manager will play a critical role in ensuring the retention and satisfaction of members enrolled in our Medicaid STAR, STAR+PLUS, CHIP, CHIP-P, Health Insurance Marketplace, and D-SNP plans. This individual will be responsible for developing, implementing, and overseeing strategies to reduce member churn, improve customer loyalty, and ensure compliance with all regulatory requirements. The Retention Manager will work closely with various internal departments, including Member Services, Sales, Compliance, and Marketing, to create and maintain a positive member experience that encourages long-term plan participation.

JOB SPECIFICATIONS 

  • Design and execute comprehensive retention strategies tailored to each specific health plan (Medicaid STAR, STAR+PLUS, CHIP, CHIP-P, Health Insurance Marketplace, and D-SNP).
  • Use data-driven insights to identify at-risk members, track retention rates, and adjust strategies as needed to improve outcomes.
  • Prepare reports on retention performance, trends, and initiatives, presenting findings to senior management.
  • Lead initiatives to proactively reach out to members, addressing concerns and ensuring they understand their benefits and options.
  • Work closely with Member Services, Marketing, Sales, and Compliance teams to ensure alignment on retention goals and consistent communication with members.
  • Ensure all retention efforts adhere to federal and state regulations, particularly for government-sponsored plans.
  • Provide training and development to the Member Services team to enhance their ability to handle retention-related inquiries and escalations.
  • Collect and analyze customer feedback to continuously improve member retention efforts and overall satisfaction.
  • Actively contributes to achievement of departmental goals, as identified in Department¿s annual business plan, including specific departmental process improvement plans, and other duties as assigned.


QUALIFICATIONS:

  • Education/Specialized Training/Licensure: Bachelor¿s degree in business administration, Health Care Management, or a related field or 7 years' experience in lieu of degree required.
  • Work Experience (Years and Area): 5+ years of experience in member retention, customer service, or healthcare management required.
  • Medicaid/Medicare plans or government-sponsored health programs preferred.
  • Management Experience (Years and Area): Strong leadership skills with the ability to manage cross-functional teams and influence outcomes.
  • Proactive approach to identifying problems and implementing solutions to reduce member churn.
  • Software Proficiencies: Proficient in Microsoft Office Suite, CRM software, and other data analytics tools.
  • Other: Familiarity with state and federal regulations related to Medicaid, Medicare, and Health Insurance Marketplace plans.


 

Application Instructions

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