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
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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