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Member Engagement

Powered by AI, perfected by people: Elevate every member interaction

Talk to an expert

Transforming member engagement

Exceptional member engagement is the foundation of loyalty, satisfaction, and long-term health outcomes. ResultsCX combines advanced AI with human empathy to deliver proactive, seamless support, helping you reduce escalations, increase retention, and empower members to take control of their healthcare journey.

Shape the future of health plans for better member engagement and health equity.

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Member engagement solutions

Health risk assessment

Identify and address member health risks early with AI-driven outreach and real-time analytics. Our solutions enable targeted assessments that close care gaps, improve outcomes, and support compliance, while our advocates guide members with empathy and clarity.

Query resolution

Deliver fast, accurate answers to every member question - whether about benefits, coverage, or care options. Our intelligent automation and expert agents resolve issues in real time, reducing confusion and eliminating friction from the member experience.

Member retention

Build lasting loyalty with proactive, personalized engagement. ResultsCX uses persona-based learning and multi-channel communication to keep members informed, supported, and satisfied, resulting in a 13% increase in satisfaction and a 21% reduction in attrition.

Grievances and appeals

Handle grievances and appeals with speed, accuracy, and compassion. Our AI-powered workflows streamline case management, while our experienced advocates ensure that every member feels heard and supported, resulting in a 54% reduction in escalations and maintaining compliance.

Enrollment and eligibility

Make every touchpoint effortless, from eligibility verification to ongoing enrollment support. We blend digital efficiency with human expertise to ensure members have the information and access they need, improving satisfaction and reducing administrative burden.

Risk identification & assessment

Proactively identify at-risk members and intervene before issues escalate. Our advanced analytics and real-time insights empower your team to deliver targeted outreach, close care gaps, and improve STAR ratings, all while keeping costs in check.

Why ResultsCX?

54% fewer member escalations

13% higher satisfaction scores

21% less friction across the member journey

Proven ability to scale for peak seasons and regulatory changes

Dedicated CMS Task Force for compliance and quality

ResultsCX healthcare solutions: Frequently asked questions

What member engagement services does ResultsCX offer?
We provide proactive health risk assessments, real-time query resolution, retention campaigns, grievance and appeals management, enrollment and eligibility support, and risk identification - delivering 54% fewer escalations and 21% less friction across the member journey.
How do you improve member retention?
Through persona-based learning, multi-channel communication, and proactive outreach, we keep members informed and engaged, resulting in a 13% increase in satisfaction and reduced attrition.
How does ResultsCX handle grievances and appeals?

Our proven advocacy model combines AI-powered workflows with compassionate agents to resolve issues quickly, maintain compliance, and ensure every member feels heard.

Ready to transform your member engagement?

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