Health Plan & Community Care Navigator

EmblemHealth; New York (NY); On-site; USD 56,000 - 99,000; Full time

Job summary

EmblemHealth is seeking a customer service oriented role that partners with onsite sales to enroll members and provide post‑sale follow‑up. The job emphasizes face‑to‑face interaction, resolving claims, enrollment inquiries, and health plan navigation, with a focus on care gaps and community referrals.

The position involves conducting onsite seminars, collaborating with Care Management and Quality teams, and supporting regional Neighborhood Care sites to enhance member experience and retention.

Qualifications

• Bachelor’s Degree required.
• 3–5 years of customer service experience (Required).
• Experience in evidence‑based health and lifestyle coaching (Preferred).
• Willingness to attend training and certification classes (Required).
• Additional experience in lieu of education may be considered (Required).
• Experience communicating with customers, assessing needs, and connecting to resources (Required).
• Knowledge of navigating medical care and managed care systems (Required).
• Excellent service knowledge, hospitality, and empathy for the customer experience (Required).
• Strong verbal, written, and interpersonal communication (Required).
• Flexibility to work across Neighborhood Care sites (Required).

Responsibilities

• Identify customer needs and solve issues related to health plans, enrollment, and wellness.
• Organize onsite health seminars and classes with EH vendors.
• Proactively communicate status of outstanding issues until resolved.
• Collaborate with sales and internal teams to improve customer experience.
• Attend weekly team meetings across sites to discuss care issues and priorities.
• Represent EmblemHealth in onsite community partner interactions.

Skills

Customer service

Communication skills

MS Office proficiency

Hospitality

Empathy

Education

Bachelor’s Degree

Tools

MS Office Suite

Job description

EmblemHealth is seeking a customer service oriented role that partners with onsite sales to enroll members and provide post‑sale follow‑up. The job emphasizes face‑to‑face interaction, resolving claims, enrollment inquiries, and health plan navigation, with a focus on care gaps and community referrals.

The position involves conducting onsite seminars, collaborating with Care Management and Quality teams, and supporting regional Neighborhood Care sites to enhance member experience and retention.