Company Statement

EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.

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Lead Customer Care Navigator - Harlem

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Customer Service
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EmblemHealth
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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.

Security Disclosure

If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.

Pay Disclosure

At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.

EEOC Statement

We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law. 

Sponsorship Statement

At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.

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