Member Advocate - PBM - Remote

This is a remote-based position within the Continental US. 

At VytlOne, our purpose is at the heart of everything we do. People join us not just for a job, but to be part of something bigger—where their work truly matters. We foster a culture of authenticity, where you’re encouraged to be yourself and a place to grow, collaborate and make an real difference. With over 1,600 passionate professionals across nearly every U.S. state, we operate as One Team, united by a bold mission and a spirit of innovation. Here, you’ll find a place where your ideas are heard, your contributions are valued, and your career can thrive.

• →Customer engagement: Field complex inbound inquiries, emails, and chat messages with professionalism and empathy.
• →Problem resolution: Efficiently and creatively resolve customer complaints, escalating complex issues to the appropriate channels when necessary.
• →Job Knowledge: Maintain deep job and service knowledge to confidently and accurately educate and serve members according to VytlOne standards.
• →Performance management: Meet or exceed key performance metrics to include, but not limited to:
  • →QA Scores
  • →Member Satisfaction Survey Scores
  • →Average Handle Time (AHT)
  • →Schedule Adherence
  • →Attendance Standards
• →Adaptability: Remain flexible and composed while navigating different member personalities, unpredictable call volumes, and changing procedures.
• →Data management: Maintain meticulous and accurate records of customer interactions within the CRM and AI tools, contributing valuable data for process improvement.
• →Process improvement: Proactively identify trends in customer feedback and issues, providing insights to management to streamline processes and enhance the member experience.
• →AI collaboration: Partner with AI-powered tools (e.g., AI copilots, knowledge bases) to access real-time information, generate call summaries, and personalize member interactions.
• →Communication: Maintain an open line of communication with all team members, including Member Services Management, and Lead Member Advocate.
• →Ongoing Training: Attend and participate in programs and meetings required by VytlOne and/or Member Services Department.
• →Compliance:
  • →Promptly report any allegations of impropriety to the Compliance Department.
  • →Comply with VytlOne’s Ethical Business Conduct policy and VytlOne’s Compliance Program.
  • →Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists.
• →Perform other job-related duties as assigned.

• High school diploma, GED, or equivalent

• Required: 2+ years Pharmacy or Health Care customer service experience.
• Preferred: Experience with PBM Contact Center, Chat Support, AI and CRM technologies.

• Empathy and emotional intelligence: Strong interpersonal skills to build rapport, actively listen, and tailor service to member emotions and intent.
• Communication skills: Excellent verbal and written communication skills, with a professional, collaborative, and friendly demeanor.
• Problem-solving aptitude: A proactive and efficient problem-solver who can think through complex situations and offer creative, effective solutions.
• Coachable mindset: Must be open to receiving feedback on performance which will be provided by the quality team, team leads, supervisors, manager and VP.
• Technical competency: Proficiency with computers and the ability to navigate multiple systems simultaneously, including CRM, AI tools, and Contact Center software.
• Resilience: The ability to manage stress and stay composed, especially in challenging situations.
• Reliability: Punctuality and dependable attendance are essential to meet operational needs.
• Adaptability: Ability to learn new skills, tasks, and technology.
• Team Oriented: Strong ability to integrate into a team environment, collaborate with diverse work styles, and positively contribute to organizational culture.
• AI proficiency: A tech-forward mindset and the ability to leverage AI-powered platforms and digital tools to enhance efficiency.

• Scheduling flexibility is a requirement; may be required to work rotating shifts, including Holidays, weekends, and nights. Some overtime may be required.

• A reliable, high-speed internet connection (preferably wired), a dedicated, distraction free workspace, and proficiency with remote communication tools are essential.
• Tech setup: You will be provided with all the tools needed to perform your role, including dual monitors, laptop, and headset.

VytlOne Website VytlOne LinkedIn

VytlOne (formerly Maxor) is an EOE, including disability/vets