Excellus Health Plan Inc.
Customer Care Field Relations Specialist I/II *Cayuga Area* 015289 (Administrative)
Summary: The Customer Care Field Relations Specialist delivers in-person support for customers, providers, representatives, and leadership on-site at business and partnership locations while acting as an external business liaison and developing relationships with key partner groups to drive new business.
Due to the nature of this role, incumbents must be vaccinated for Covid-19.
Essential Responsibilities/Accountabilities:
Level I:
• Provides in-person support for customers, representatives, and leadership on-site at multiple business and partnership locations.
• Establishes relationships and partnerships with key partner groups, including senior organizations, community centers, residences, associations, support groups and others to drive new business.
• Attends meetings and/or trainings as a representative of Customer Care and shares the information learned with the team.
• Responds to requests for assistance to provide on- and off-site support regarding new and existing business needs.
• Serves as business liaison to cross-functional support areas (sales, marketing, retention, etc.).
• Has strong knowledge and background on multiple lines of business and handling complex/escalated customer issues to provide proactive education to internal and external customers and business partners.
• Understands performance and proactively identifies issues and trends affecting the Health Plan or customer satisfaction with ability to provide suggested action plans for improvement.
• Promotes customer satisfaction in all activities and functions including effectively handling members and providers who require the next level of assistance.
• Ensures problems are resolved with accuracy, efficiency and a high level of customer and provider satisfaction while maintaining the required departmental performance/quality standards.
• Serves as a high-quality, clear, and concise communicator of product options to drive consumer understanding and confidence while initiating sales opportunities to increase membership.
• Researches, interprets and responds to inquiries via all member/provider channels, concerning our products, services and policies in accordance with MTM, Corporate Service strategy, NCQA, NYSDOH, OLAs and other legislative/contractual requirements.
• Demonstrates commitment to continuous improvement through sharing of best practices across the entire organization.
• Accountability with strong business, planning, accuracy, and time management skills to self-manage and prioritize while performing multiple tasks and responsibilities.
• If issued a company cell phone, responsible for being readily available to assist members, providers, billing representatives, leadership, etc. at any location while traveling.
• Creates & presents internal/external reports with ability to identify internal/external staff training needs.
• Executes on departmental and organizational initiatives.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values and adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.
Level II:
In addition to Level I responsibilities:
• Qualifies prospects onsite per Centers for Medicare & Medicaid Services (CMS) Regulations and closes sale wherever possible and as appropriate.
• Employs professional consultative sales methodology to present product offerings within the context of a given prospect's needs.
• Completes and submits enrollment forms for closed sales within the specified timeline.
Minimum Qualifications:
Note of Classification: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.
All Levels:
• Associates degree in Business Administration, Health Care Administration, Health Economics or related with 3 years of related work experience. In lieu of degree, 5 years of related work experience.
• Ability to multi-task in order to efficiently resolve customer concerns, by actively listening to the customer, navigating screens on the computer, typing call documentation and speaking to the customer simultaneously.
• Excellent navigational skills required, including the ability to navigate in a Windows environment. Skillful at working between multiple programs and applications at the same time.
• Adept at communicating effectively and diplomatically while working as a collaborative team member.
• Organizational, reasoning and problem solving skills.
• Strong organizational skills and ability to prioritize & follow through, and work in fast paced environment while remaining professional and focused under multiple pressures and demands.
• Must have ability to travel within NYS based on business needs with a valid Driver's License.
• Conducts and attends meetings representing the organization with varies levels of leadership.
Level II-In addition to Level I:
• Valid NYS Accident and Health License
• Knowledge of local/national and Medicare benefit programs and participating plan operations.
• Knowledge of Health Plan and Univera business offerings.
• Experience with giving formal/informal training.
• Expertise in creating instructional material, presentation, group facilitation, and a variety of delivery methodologies,
• Strong written and oral communication skills.
• Ability to problem solve for effective conflict resolution.
• Sound human relation skills
• Self-motivated and able to work independently as well as on intra/inter-departmental teams.
• Expertise of personal computer skills including Word, Windows, Excel, PowerPoint, etc.
Physical Requirements
Travel throughout the regions may be required.
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The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.
Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.
OUR COMPANY CULTURE:
Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
Non Manager