Bilingual Spanish Customer Care Navigator- Onsite (Jackson Heights/Elmhurst Queens)
EmblemHealth · New York, NY
- On site
- Full-time
- $75,000 / year
- New York, NY
Job highlights
- Assist customers with enrollment, claims, and benefits.
- Provide health plan navigation and wellness coaching.
- Resolve complex customer service issues.
- Conduct community outreach and seminars.
- Collaborate with internal and external partners.
About the role
Summary Of Position
Work closely with onsite sales colleagues to identify customers in need of enrollment services and provide post sales customer service follow-up. 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. Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to explain and resolve complicated customer service issues, close care gaps, helping complete HRAs, enabling higher retention of members within the neighboring community. Help conduct seminars and workshops on premises and will play an important role in class offerings for the department. Collaborate with enterprise team members on member retention efforts and special projects within the location including: Care Management and Quality to understand member needs in the community as they relate to gaps in care; and quality efforts to provide effective in person and outreach services within the community. Provide post sales customer service follow-up with Sales colleagues, both onsite and in the field within the region, to follow up on member customer service and care needs. Work with ACPNY teams, both co-located and within the region, to aid in care gap issues, especially as they relate to social needs and customer service follow up. Represent EmblemHealth to all visitors to the sites, including internal and external partners, groups and leaders. Maintain a primary Neighborhood Care location but also support multiple Neighborhood Care sites within a region.
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 (EH) 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 the manager to deliver and organize onsite health seminars and classes, including EH vendor-led classes.
- Proactively communicate with customers, EmblemHealth departments 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 partners such as AdvantageCare Physicians, 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
Education, Training, Licenses, Certifications
- Bachelor’s Degree
Relevant Work Experience, Knowledge, Skills, And Abilities
- 3 – 5+ years of experience working with customers in customer service, medical or managed care environment.
- Experience in evidence‐based health and lifestyle coaching techniques.
- Ability and willingness to attend appropriate training and certification classes. Additional experience/specialized training may be considered in lieu of educational requirements.
- 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, and health and wellness.
- Ability to demonstrate excellent service knowledge and hospitality, and optimistic warmth and empathy for the customers’ experience.
- Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences.
- Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.).
- Technologically savvy, with the ability to quickly learn and navigate different information technology systems.
- Flexibility to work in different Neighborhood Care sites when needed.
Key skills/competency
- Customer Service
- Health Plan Navigation
- Enrollment Services
- Community Referrals
- Health and Wellness Coaching
- Claims Inquiry
- Benefit Inquiry
- Member Retention
- Customer Issue Resolution
- Bilingual Spanish
Skills & topics
- Customer Service
- Bilingual
- Spanish
- Healthcare
- Customer Care
- Navigator
- Enrollment
- Claims
- Benefits
- Health Plan
- Managed Care
- Community Outreach
- Queens
- Jackson Heights
- Elmhurst
How to get hired
- Tailor your resume: Highlight customer service, managed care, and bilingual Spanish skills.
- Showcase your experience: Emphasize problem-solving and communication with diverse audiences.
- Demonstrate empathy: Prepare examples of providing warm, helpful customer interactions.
- Research EmblemHealth: Understand their mission, services, and community focus.
- Prepare for interviews: Be ready to discuss customer scenarios and your resolution strategies.
Technical preparation
Practice using MS Office Suite applications.,Familiarize yourself with health insurance systems.,Review customer relationship management tools.,Understand common health plan terminology.
Behavioral questions
Describe a time you helped a difficult customer.,How do you handle multiple customer needs?,Share an experience resolving a complex issue.,How do you show empathy to customers?
Frequently asked questions
- What are the primary responsibilities of a Bilingual Spanish Customer Care Navigator at EmblemHealth?
- As a Bilingual Spanish Customer Care Navigator at EmblemHealth, your primary responsibilities include assisting customers with enrollment, claims, and benefits inquiries, providing health plan navigation and wellness coaching, resolving complex customer service issues, conducting community outreach and seminars, and collaborating with both internal teams and external partners to ensure member satisfaction and retention.
- What qualifications are essential for the Bilingual Spanish Customer Care Navigator role?
- Essential qualifications for this role include a Bachelor’s Degree, 3-5+ years of customer service experience in a medical or managed care environment, experience with health and lifestyle coaching techniques, strong communication and interpersonal skills, proficiency in MS Office, and the ability to learn new IT systems quickly. Bilingual Spanish fluency is critical.
- Is this a remote or onsite position?
- This is an onsite position, requiring you to work directly at an EmblemHealth Neighborhood Care location in Jackson Heights/Elmhurst, Queens.
- What is the typical career path for a Customer Care Navigator at EmblemHealth?
- While specific paths vary, a Customer Care Navigator role can lead to opportunities in team leadership, specialized customer support roles, or management positions within EmblemHealth's customer service and community outreach departments. Your experience in navigating complex member issues and community engagement can be valuable for advancement.
- How does EmblemHealth support its Customer Care Navigators?
- EmblemHealth provides opportunities for ongoing training and certification classes, encourages collaboration with experienced managers and team members, and utilizes various enterprise systems to aid in resolving member issues. They also foster a team environment through weekly meetings to discuss customer care strategies and company priorities.
- What kind of community engagement is involved in this role?
- This role involves significant community engagement, including conducting health seminars and workshops, connecting members with local resources, and collaborating with community partners and leaders. You will represent EmblemHealth within the community and help address member needs, including social needs.
- How important is bilingual Spanish fluency for this role?