Job Description
Job Description
UNITE HERE HEALTH serves over 200,000 workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!
THIS POSITION IS LOCATED IN THE SAN JOSE, CA AREA. TRAVEL BETWEEN SAN JOSE, YOSEMITE, AND MONTEREY, CA
FLUENCY IN SPANISH (BILINGUAL REQUIRED)
The Sr. Member Services Specialist is the face of our organization (aka the “Fund), especially to participants, and to provide benefits, claims, eligibility, and health care education and information to this multi-cultural community. The Sr. Member Services Specialist shares the UNITE HERE HEALTH message by encouraging the utilization of benefits according to plan provisions and best healthcare value while optimizing the member’s service experience.
ESSENTIAL JOB FUNCTIONS AND DUTIES
- Acts as the positive “face” of the Fund as the main point of contact for the Fund’s participants, unions, employers, providers, and vendors
- Provides benefit plan and eligibility information to participants, providers, unions, employers, and others for all Fund plans
- Performs telephonic enrollment functions and in-person outreach as needed, including hosting and attending enrollment events
- Provides proactive education to participants by phone, in person at the office, and at the worksite, including presentations
- Receives and records telephone and walk-in inquiries regarding plan benefits
- Conduct root cause analysis on walk-in inquiries and provide management with recommendations on how to improve the member experience
- Maintains up-to-date knowledge of all systems and sources relating to plan benefits, processes, policies, etc. that will affect the performance of daily tasks
- Seeks management assistance on issues unable to resolve in a timely manner
- Maintains awareness of work volumes and service levels
- Assists in special projects as requested by management
- Sets goals and achieve measurable results
- Assists in participant outreach and navigating them to take steps to get involved in programs to improve their health
- As assigned, works outside traditional office hours and traditional office locations to reach participants
- Utilizes effective listening skills to recognize and communicate issues to management, including trends and anomalies
- Performs research on benefit issues and initiates corrective action if needed
- Trains Member Services staff on complex skillsets
- Handles escalated participant and provider complaints
- Makes improvement recommendations to benefit materials, forms, and processes
- Exemplifies the Fund’s values in leading and fostering a respectful, trusting, and engaged culture of inclusion and engagement
ESSENTIAL QUALIFICATIONS
- 2 ~ 3 years of direct experience minimum in a healthcare, insurance, Union, or community engagement environment
- Associate’s degree in Business or Healthcare Administration or related field or equivalent work experience required
- Fluency in Spanish, (Bilingual required)
- Working knowledge and experience in customer service
- Call center experience
- Experience with diverse communities
- The ability to travel as needed (25% - 50%) - Travel between San Jose, Yosemite, and Monterey, CA
Salary range for this position: Hourly $28.10 - $34.46. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.
Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) as a hybrid employee with the ability to travel to various California locations onsite.
We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).
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