Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Customer Care Navigator

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Manager & Professional
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1914K Requisition #
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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.

Responsibilities:
  • 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.
Qualifications:
  • Bachelor’s Degree strongly preferred
  • Bilingual in Spanish and English strongly preferred
  • 2-3 years of experience working with customers in 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
  • 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

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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