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Lead Customer Care Navigator

EmblemHealth
United States, New York, New York
Aug 19, 2025

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.
  • Work closely with onsite sales colleagues to identify customers in need of enrollment services and provide post-sale
    customer service follow-up.
  • Act as site expert on company product offerings and operations by attending all general, product and operation training
    sessions and by regularly reviewing all training notices.
  • Act in a primary support role to other regional team members.
  • Work with the Regional Manager to manage onsite events and track site expenses.
  • Manage site decisions when the Regional Manager is unavailable and/or upon request.
  • Represent EmblemHealth to all visitors to the sites, including internal and external partners, groups and leaders.
  • Back up the Regional Manager's site responsibilities across the region but will have a primary work location.


Principal Accountabilities



  • Identify customer needs and help solve customer issues related to health plans, health and wellness and enrollment
    within regulatory guidelines; providing direct guidance or identifying other EmblemHealth and community resources
    to find customer solutions, conduct customer needs assessment, and provide education on condition management.
  • Understand and maintain excellent working knowledge of EmblemHealth products, services and technology
    platforms.
  • Act in a primary support role to other regional team members. Document interactions in support of quantitative
    metrics for the site and department.
  • Work with manager to organize onsite health seminars and classes, including EmblemHealth vendor-led classes.
  • Act as site lead and make site decisions to fill in for Regional Manager's absence or when requested, representing
  • EmblemHealth with internal and external partners and community leaders.
  • Proactively communicate with customers, EmblemHealth departments and community partners the status of any
    outstanding customer issues until solved. Effectively describe final resolution to customer.
  • Attend training sessions, review all training emails/documents and review all items with team members ensuring
    comprehensive knowledge of items.
  • Participate in weekly meetings with manager and team members across sites to discuss training knowledge,
    customer care issues, improvement opportunities, community offerings, and other site and company priorities
  • Work together with sales team to identify customers in need of enrollment services and post-sale 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


Qualifications

Education, Training, Licenses, Certifications



  • Bachelor's Degree


Relevant Work Experience, Knowledge, Skills, and Abilities



  • 4 - 6 years of experience working with customers in customer service, medical or managed care environment.
  • Additional experience/specialized training may be considered in lieu of educational requirements.
  • Bilingual Language Skills - Spanish/ Chinese Dialect
  • Experience in evidence-based health and lifestyle coaching techniques preferred; willingness to attend appropriate training
    and certification classes.
  • Experience communicating directly with customers, assessing needs, and connecting customers with resources.
  • Knowledgeable on how to navigate all aspects of medical care and managed care system; health and wellness.
  • Ability to demonstrate excellent service knowledge and hospitality.
  • Possesses optimistic warmth and empathy for the customers' experience.
  • Technologically savvy, with the ability to quickly learn and navigate different information technology systems.
  • Flexibility to work in different Neighborhood Care sites when needed.

Additional Information


  • Requisition ID: 1000002626
  • Hiring Range: $68,040-$118,800

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