[Hiring] Member Experience Guide @SCAN Health Insurance

Role Description

The Member Experience Guide serves as a trusted partner to our members, owning each interaction from inquiry to resolution with empathy, clarity, and accountability. Guided by a deep sense of Member Obsession, this role puts members first in every decision, ensuring their needs are understood, prioritized, and resolved with urgency and care. Member Experience Guides embrace a Champion’s Mindset, welcoming challenges and persevering until the best possible outcome is achieved. Through courageous problem-solving and a commitment to excellence, this role reduces member effort, strengthens trust, and delivers meaningful experiences that build long-term loyalty.

You will

• Connect with empathy and member-first focus: Build trust through active listening, acknowledging emotions, and demonstrating Member Obsession by prioritizing the member’s needs in every interaction.
• Own the end-of-end experience: Take full accountability for resolving inquiries, requests, and concerns, navigating systems and teams with a Champion’s Mindset to achieve first-call resolution whenever possible.
• Deliver “path to yes” solutions: Apply critical thinking and Courageous Challenge by seeking solutions beyond the obvious and addressing barriers directly to meet member needs.
• Navigate complexity with clarity and confidence: Translate benefits, claims, and processes into simple, actionable guidance, ensuring members feel supported and informed.
• Demonstrate tenacity and perseverance: Persist through complex or ambiguous situations, exhausting available resources before escalating and maintaining focus until resolution is achieved.
• Provide clear next steps and follow-through: Take ownership with Resolve, set expectations and ensure closure through proactive communication and follow-up.
• Challenge for better outcomes: Use Courageous Challenge to raise concerns, identify process gaps, and advocate for improvements that enhance the member experience.
• Contribute to continuous improvement: Embrace Responsible Disruption by identifying opportunities to improve workflows, reduce friction, and enhance service delivery.
• Uphold service excellence standards: Demonstrate Relentless Leadership in everyday actions by consistently delivering high-quality, empathetic, and effective service.

Qualifications

• High School Diploma or Equivalent Experience
• 1+ years of customer service experience in a contact center, healthcare, hospitality, or service-oriented environment
• Experience resolving customer issues, managing multiple systems, and handling high-volume interactions
• Required: English (Read, Write, Spoken)

Skills/Abilities

• Empathy – Demonstrates the ability to recognize and validate member emotions, ensuring every interaction feels personal, respectful, and understood.
• Compassion – Transforms empathy into action by proactively working to ease member concerns and improve outcomes.
• Tenacity – Displays persistence and determination, embracing a Champion’s Mindset to resolve even the most complex challenges.
• Resolve – Owns outcomes fully, ensuring issues are driven to closure with clear communication and follow-through.

Experience Preferred

• Medicare Advantage, Medicaid, or healthcare experience
• Experience in a provider office, medical group, hospital, or health plan
• Hospitality or high-touch service experience
• Caregiving experience demonstrating compassion and advocacy
• Preferred: Fluency in one or more of the following languages in addition to English:
  • Spanish
  • Cantonese
  • Mandarin
  • Korean
  • Vietnamese

Benefits

• Work mode: Remote
• A quarterly employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO) - 8 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!