Customer Care Navigator (Duane St) Job at ConnectiCare

ConnectiCare New York, NY 10004

Summary of Position
  • Interact face-to-face with customers, assisting in providing complete resolution of customer concerns including claims,
benefit and enrollment inquiries through health plan navigation, health and wellness coaching and community referrals.
  • Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to explain and resolve
complicated customer service issues, close care gaps, helping complete HRAs, enabling higher retention of members within
the neighboring community.
  • Help conduct seminars and workshops on premises and will play an important role in class offerings for the department.
  • Collaborate with enterprise team members on member retention efforts and special projects within the location including:
Care Management and Quality to understand member needs in the community as the relate to gaps in care and quality
efforts to provide effective in person and outreach services within the community.
  • Provide post sales customer service follow-up with Sales colleagues, both onsite and in the field within the region, to follow
up on member customer service and care needs.
  • Work with ACPNY teams, both co-located and within the region, to aid in care gap issues, especially as they relate to social
needs and customer service follow up.
  • Represent EmblemHealth to all visitors to the sites, including internal and external partners, groups and leaders.
  • Maintain a primary Neighborhood Care location but also support multiple Neighborhood Care sites within a region.
Principal Accountabilities
  • Identify customer needs and help solve customer issues related to health plans, health and wellness and enrollment
within regulatory guidelines.
  • Provide direct guidance or identify other EmblemHealth and community resources to find customer solutions,
conduct customer needs assessment, education on condition management and care gaps.
  • Understand and maintain excellent working knowledge of EmblemHealth products, services and technology
platforms.
  • Document interactions in support of quantitative metrics for the site and department.
  • Work together with sales team to identify customers in need of enrollment services and post sales customer service
follow-up. Proactively support operational aspects of other internal partners such as AdvantageCare Physicians,
product, customer service and quality to help improve customer experience and operations.
  • Work with manager to deliver and organize onsite health seminars and classes, including EH vendor-led classes.
  • Proactively communicate with customers, EmblemHealth departments and community partners the status of any
outstanding issues until solved.
  • Deliver final resolution to customer.
  • Participate in weekly meetings with manager and team members across sites to discuss customer care issues,
improvement opportunities, community offerings, and other site and company priorities
  • Represent EmblemHealth at onsite interactions with community partners and leaders.
Education, Training, Licenses, Certifications
  • Bachelor’s Degree.
Relevant Work Experience, Knowledge, Skills, and Abilities
  • 3 - 5 years of experience working with customers in customer service, medical or managed care environment required
  • Experience in evidence-based health and lifestyle coaching techniques preferred; willingness to attend appropriate training
and certification classes required
  • Additional experience/specialized training may be considered in lieu of educational requirements required
  • Experience communicating directly with customers, assessing needs, and connecting customers with resources required
  • Knowledgeable on how to navigate all aspects of medical care and managed care system; health and wellness required
  • Ability to demonstrate excellent service knowledge and hospitality required
  • Must be able to demonstrate optimistic warmth and empathy for the customers’ experience required
  • Technologically savvy, with the ability to quickly learn and navigate different information technology systems required
  • Bilingual English Spanish preferred
  • Flexibility to work in different Neighborhood Care sites when needed required

Additional Information

  • Job Type: Standard
  • Schedule: Full-time
  • Employee Status: Regular
  • Requisition ID: 1000000629
  • Hiring Range: $63,000-$75,000



Please Note :
blog.nvalabs.org is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, blog.nvalabs.org provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.