The Customer Care Navigator will 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. The Customer Care Navigator will help conduct seminars and workshops on premises, and will play an important role in class offerings for the department. The Customer Care Navigator will work closely with onsite sales colleagues to identify customers in need of enrollment services and provide post sales customer service follow-up. The Customer Care Navigator will positively represent EmblemHealth to all visitors to the sites, including internal and external partners (including AdvantageCare Physicians), groups and leaders. Customer Care Navigator will have a primary location in 2655 Richmond Avenue but will also support other planned Neighborhood Care locations in Staten Island to open in 2019.
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, education on condition management. 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 with manager to deliver and organize onsite health seminars and classes, including EmblemHealth vendor-led classes.
Proactively communicate with customers, EmblemHealth departments, ACPNY and community partners the status of any outstanding issues until solved. Effectively describe final resolution to customer.
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 groups such as product, customer service and quality to help improve customer experience and operations.
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.
Bachelor’s Degree strongly preferred
Bilingual in Spanish and English required
2-3 years of experience working with customers in medical or managed care environment required required
Experience in evidence-based health and lifestyle coaching techniques preferred; willingness to attend appropriate training and certification classes 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
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 in NYC when needed required