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talk to us

Licensed advocate solution

Licensed experts, trusted advocacy

Talk to an expert

Elevating healthcare engagement and member experience

Health plan interactions are pivotal moments that shape member trust and satisfaction. Navigating benefits, resolving claims, and addressing concerns require more than just information—they demand empathy and expertise. Health plans must also scale rapidly during peak seasons like open enrollment, while maintaining compliance and service excellence. These challenges create immense pressure, making it essential to have a skilled, member-focused team that delivers seamless, high-quality support.

With over 20 years of experience in healthcare CX, we’ve helped some of the industry’s biggest brands elevate their member experience. Our Health Advocacy Model ensures every interaction is handled with expertise, empathy, and efficiency. Members engage with our licensed advocates highly trained professionals who not only provide accurate information but also foster trust and loyalty.

By combining deep industry knowledge with rigorous compliance and a member-first mindset, our unique model delivers improved member satisfaction and plan outcomes.

retail fraud manageent

#ResultsMatter

Our health insurance sales team delivered a strong 2024 AEP/OEP season, exceeding their goals for 9 out of 12 clients’ lines of business and ranking #1 vs. all competitors for 6 out of 7 clients.

113% delivery vs. goal

For a health plan’s marketplace team with record breaking 21.3% conversion rate.

41.25% overall AEP conversion rate

For a state-wide health insurer team. Named ‘Trusted Vendor of Choice’ and awarded 100% of white glove retention business.

140% delivery vs. goal

For a Fortune 100 managed healthcare client, maximizing pay for performance.

Industry leading capabilities

Our Healthcare Persona Training transforms agents into trusted advocates, equipping them with the skills to build emotional connections, simplify complexities, and take the right actions for member advocacy. Grounded in our Five Essential Engagement Habits, this approach fosters a member-centric experience that enhances trust, loyalty, and resolution-driven sales. By personalizing interactions, demonstrating empathy, and proactively addressing care needs, we create a seamless and supportive journey—one that directly links member satisfaction to business success.

Proven engagement practices that build trust and achieve higher conversion rates
Inbound new customer acquisition
Inbound new customer acquisition
Personalized approach built on data-driven insights to reduce churn and drive brand loyalty
Retention
Retention
Maximized revenue per sale, ensuring members have access to all your brand offerings, increasing member loyalty
Upsell/Cross sell
Upsell/Cross sell
Efficient, targeted dialing strategies that complement inbound campaigns; engaging, converting, and maximizing your marketing ROI

Conversational AI-led sales solutions to improve CTS and maximize revenue
Outbound sales
Outbound sales
Win-back strategies that reduce churn and strengthen loyalty
Member win-back
Member win-back
Stellar seasonal ramp record, AI-enhanced onboarding, proven agent incentive structures, and prescriptive sales coaching
Renewals/Plan change
Renewals/Plan change

How we do it

We leverage curated analytics, AI-driven insights, and collaborative learning to drive successful sales conversations. Our Consultative Selling Approach focuses on creating needs-based interactions, ensuring solutions align with customer expectations and add real value. From agent selection to continuous training, we develop sales competencies that reflect your business strategy, fostering adaptability and effectiveness at every stage.

Strategic licensed advocate recruitment

We source top licensed healthcare advocates through national databases, industry job boards, and professional networks. Targeted market sourcing focuses on regions with a high concentration of licensed professionals for optimal hiring. Partnerships coupled with our employee referral program further strengthen our pipeline. To ensure success, we prioritize sales-oriented candidate profiling and use pre-hire assessments like Traitify to evaluate problem-solving and sales aptitude.

Targeted training

Our Learn360 Healthcare Sales Training empowers advocates to engage, educate, and guide members to the right plan. Using a structured consultative approach, they discover customer needs, personalize education, offer tailored recommendations, and provide effective resolution building trust and delivering exceptional member experiences.

Tech-driven coaching

We use real-time speech analytics and data-driven coaching to sharpen advocate performance. Advocates receive instant feedback on key sales behaviors, scripting, and techniques, while performance tracking empowers continuous improvement. Our structured coaching framework empower, prepare, deliver, review—ensures faster time-to-proficiency, higher conversions, and an exceptional sales experience.

What sets us apart

Marketplace sales expertise
Dedicated licensing practice
AEP ramp excellence
  • With deep experience in Marketplace programs since the launch of the Affordable Care Act (ACA), we specialize in enrollment, member services, and provider support while ensuring compliance with ACA regulations.
  • Our Licensing Department ensures full regulatory compliance, verifying that all insurance advocates are licensed in required states before handling sales.
  • We meticulously inspect advocate status to prevent any compliance risks. With licensed advocates in all 50 states, we swiftly secure nonresident licenses within 1-3 days for eligible candidates.
  • During off-peak seasons, we focus on operational improvements, advocate education, license renewals, and compliance updates to maintain readiness and mitigate risks.
  • A well-defined talent acquisition approach combines internal resources, seasonal hiring pools, and AI-driven assessment tools to onboard best-fit sales candidates quickly.
  • Advanced technology deployment, including RPA, AI-powered knowledge tools, and automated disclosures, enhances efficiency and compliance.
  • A closed-loop feedback system, driven by our PMO team, continuously refines enrollment processes by capturing lessons learned, tracking initiatives, and addressing potential member pain points before they escalate.

5,400+

Healthcare advocates

~40M

Languages

10,000+

Peak season advocates

1,200+

Liecensed agents

230%

Revenue growth 2018 - 2023

22

Healthcare support locations including W@H

32,000

Licenses managed by your licensing department

7 years

Major healthcare players supported with licensed agents each peak season

Discover new ideas, insights & solutions

Navigating 2025 AEP/OEP

Blog

July 30, 2024

Award-winning Intelligent Automation Solution Helps Leading Health Plan Reduce Agent Onboarding and Offboarding time by 50%

Case Study

April 3, 2024

ResultsCX’s Largest Seasonal Ramp Surpasses Medicare Advantage Clients’ Conversion Goals

Enrollment

Case Study

July 26, 2023

Transform your customer experience, act now!

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