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Be ready to walk through de-escalating a frustrated member, explaining a benefits concept simply, and prioritizing multiple outreach tasks. Ask how success is measured for engagement and what systems the guide team uses day to day.
Strong fit if you like remote member-facing healthcare work, patient communication, and process-driven support inside a large insurer/IDN rather than pure clinical care.
As a Member Engagement Guide at Highmark Health, a typical day centers on helping health-plan members navigate benefits, care options, and digital or phone support channels. You may explain coverage in plain language, follow up on outreach campaigns, document interactions, and escalate clinical or complex cases to the right internal teams while keeping a service-first tone.
Build strength in health-plan literacy, empathy under pressure, CRM/call-center tooling, and clear written notes. No formal certification path is specified in the available data.
Yes. The listing describes a remote Member Engagement Guide role focused on Central Pennsylvania.
It is a large nonprofit-linked healthcare company and insurer based in Pittsburgh, with an integrated delivery network and related subsidiaries.
Customer service, call-center, care coordination, or health-insurance operations experience transfers well; formal certs are not required by the provided data.
Website: highmarkhealth.com
Highmark Inc is an American nonprofit healthcare company and integrated delivery network based in Pittsburgh. It is a large individual health insurer in the United States, which operates several nonprofit and for-profit subsidiaries.
Public cache only — not an employee review.
Highmark Health is seeking a Member Engagement Guide to work remotely across the Central PA territory, supporting communities including Harrisburg, Carlisle, York, Mechanicsburg, Lancaster, and State College. This is a full-time, field-based role for a relationship-driven professional who can help members navigate their care and coverage with confidence. About the Role As a Member Engagement Guide at Highmark Health, you will partner closely with the Sales Client Management and Sales Executive teams to shape member transition strategies that connect individuals to AHN and trusted community providers. Your work will reduce care disruption, guide members toward high-value, accessible care, and influence outcomes from a cost-of-care perspective across this remote Central PA territory. Key Responsibilities Help members make informed choices by identifying the right in-network providers for their needs and clearly explaining how their insurance benefits and healthcare costs work. Act as a member advocate—coordinating medical record transfers, securing timely appointments, and helping resolve claims or billing questions. Highlight the quality, outcomes, and value of AHN and partner network providers, steering members toward cost-effective care closer to home. Design fresh ways for members to experience patient-focused care firsthand across multiple specialties. Collaborate with the Sales team to build and execute strategies at enrollment events that grow and retain membership and support profitability for HMIG, dental, and vision products regionally and nationally. Schedule and lead meetings with employers, members, and provider partners. Surface operational issues and process-improvement opportunities, routing feedback to the right internal teams such as Product Management, Membership, Claims, and eMarketing. Develop incentive models and executive relationships that drive measurable changes in member behavior. Qualifications Bachelor's degree in Business, Communications, or a related field, or six years of progressive related experience in its place. Three years of sales or client consulting experience, ideally within the insurance industry. Producer License in Life, Accident & Health preferred. Strong relationship-building, communication, and influencing skills at every organizational level. Proven success in a matrixed environment, with sharp analytical, financial, presentation, and writing abilities. Willingness to travel 0%–25% within the territory. About Highmark Health Highmark Health is a national health and wellness organization committed to delivering…
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