Resp & Qualifications

PURPOSE:

CareFirst is launching CareFirst Engagement Centers (CECs) to support our members to find the right insurance product, navigate the complexities of healthcare, and access care and other community resources. The Centers will deepen our relationships and engagement with our local CareFirst communities, especially with some of our more vulnerable members. The CEC Navigator role will be based in our first center in Canton/Baltimore, Maryland. This role will provide members with a superior customer experience by building working relationships with teams across the company, solving difficult problems and helping members to navigate the health care system and social services. This position requires a clear temperament for in-person customer service and will be called upon to regularly handle all types of service issues across CareFirst lines of business.

ESSENTIAL FUNCTIONS:

• Investigates and resolves sensitive, complex, and/or high priority customer service inquiries. Maintains an in-depth knowledge of lines of business, claims procedures, membership, accounting, marketing, and regulations related to the health insurance industry.

• Exercises good judgment in making decisions in the absence of management. Supports the CEC Managers and Associates in the daily operation of the center, including supporting timely and accurate implementation of quality improvement projects. Performs additional job-related duties or special projects as requested by the supervisor.

• Maintains technical quality in responding to customers. Identifies problems with workflow, procedures or benefits and then researched to identify root cause and potential solutions in collaboration with CEC Management.

• Interacts with Advisors and Advocates and other specialists across CareFirst to identify global, procedural, or patterns of problems and initiates resolution to these problems by recommending departmental procedure/process changes to the supervisor. Communicates with others to prevent future problems.

• Navigates CareFirst and community resources to address health and social needs to transform the healthcare experience with and for our members and communities.

QUALIFICATIONS:

Education Level: HS Diploma or equivalent.

Experience: 3 years experience in community relations, outreach and customer services.

Knowledge, Skills and Abilities (KSAs):

• Consistently high customer satisfaction.
• Completion of predetermined list of internal/external classes.
• Proven track record of over-achieving standards.
• Performance above and beyond personal and/or team qualitative & quantitative targets.
• Strong CRM systems knowledge and practices.
• Ability to work well with people, strong verbal and written skills as well as leadership and motivational skills.

Preferred Qualifications:

• Fluently Bilingual (Spanish/English)
• In-person customer service experience

Department

Department: Community Engagement Ctrs

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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