Health Plan Navigator I - Keaau

Hawaii Medical Service Association; Hawaii; On-site; USD 42,000 - 60,500; Full time

Job summary

HMSA in Hawaii is seeking a Health Plan Navigator to guide members through HMSA plan benefits and programs. The Navigator will assist customers primarily by phone and will also support in-person, virtual, and online servicing tools to improve member experience and outcomes.

You will inform members about costs, help them use plan benefits, manage inquiries, and coordinate with other departments to resolve issues while meeting performance standards.

Qualifications

• Associate degree or equivalent education/experience.
• Strong verbal and written communication skills.
• Proficient with Word, Excel, Outlook and PowerPoint.
• Good PC navigation and basic IT skills.

Responsibilities

• Assist customers by phone with timely, accurate service.
• Document and close customer cases with quality resolution.
• Participate in training to service HMSA plans.
• Support customers through written, online, or in-person channels.

Skills

Verbal communication

Written communication

Customer service

Basic IT skills

Education

Associate's degree or equivalent

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

PowerPoint

Job description

Pay Range: $42,000 - $60,500

Note: Individuals typically begin between the minimum to middle of the pay range

The Health Plan Navigator guides members through the complexities of HMSA's health plan benefits and programs. The Navigator will assist and build relationships with customers primarily by phone, and will also provide support in-person, virtual, and through online servicing tools. The Navigator is responsible for consumer experience, improving and maintaining health outcomes, informing members on health care cost and utilizing their HMSA plan benefits.

Minimum Qualifications

• Associate's degree or equivalent combination of education and work experience.
• Effective verbal and written communication skills.
• Basic working knowledge of Microsoft applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
• Intermediate PC knowledge and navigation proficiency.

Duties and Responsibilities

• Assist customers in a timely and accurate manner in phone interactions. Maintain quantity, timeliness, accuracy, and quality performance within established standards that support HMSA's ability to comply with customer performance requirements, while receiving and responding to inquiries. Conduct research for routine inquiries. Apply basic analytical and problem-solving skills to resolve customer inquiries and issues. Research relevant information and make recommendations. Manage inventory of inquiries and coordinate with departments.
  • Resolve servicing interactions by documenting and closing customer cases. Work with peers, management, and HMSA business areas to bring accurate and quality resolution for customers while continuing to follow performance guidelines.
• Participate in training to learn the foundation and basics of servicing HMSA's customers. Participate in training to be proficient in servicing at least two HMSA plans.
• Participate in servicing customers through options other than the phone. This could be written or online inquiries, in-person servicing or performing off-line data or project work.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

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