Member Services Community Engagement Representative - Manhattan

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Responds to member inquiries and requests concerning benefits, services, clinical coordination, claims and complaints within a community center environment to ensure high quality customer service to members. Researches and responds to member claim inquiries, performs required member outreach, conducts outbound call campaigns, and participates in health events.

• High School Diploma or equivalent required. Associate's/bachelor's degree preferred.
• Bilingual Spanish required
• 5-7 years of experience in customer service/community relations in a healthcare environment.
• Prior experience in one or more of the following: Medicare, Medicaid, health insurance, geriatric population and or utilization/care management process is preferred.
• Experience in a call center or community center setting strongly preferred.
• Microsoft Office.
• Excellent verbal, communication, and active listening skills.
• Interdepartmental communication system and phone system.
• Ability to identify and resolve problems.
• Ability to work independently.
• Excellent time management, prioritization, and organizational skills.
• Demonstrates professionalism and is well presented.
• Proficient in systems, Market Prominence, Guiding Care, Symplr, InComm OTC, Salesforce, with Health Rules Payor issue analysis and problem solving preferred.