Health Advocate - My Navigator - Operations - Paramount

Paramount Health Care, a ProMedica Health Plan, offers insurance products across six Midwest states. This Ohio-based company, headquartered in Toledo, has more than 685 employees dedicated to serving their health plan members.  

Paramount offers Medicare Advantage and Marketplace Exchange health plans for individuals and families. Paramount maintains accreditation by the National Committee for Quality Assurance (NCQA) for their HMO and Medicare Advantage products.

In addition, Paramount has a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation, as well as vocational rehabilitation, life-care planning and wellness.

As a part of ProMedica, Paramount is driven by ProMedica’s mission to improve your health and well-being. ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. Paramount strives to provide an exceptional experience to every member. For more information about Paramount, please visit our website at paramounthealthcare.com.

The Health Advocate establishes the first impression of Paramount to its ProMedica members.  As such, it is critical that the Advocate employs a high level of customer service quality. The Advocate facilities resolution of member issues and concerns, and proactively engages with members and providers to ensure the highest quality care and customer service.

• Manages multi-line phone system and serves as member services representative and community/medical liaison by responding to requests from the region and local community for health information, physician referral and consultation services, event/class registration, assisting with insurance questions and other referrals to meet customer needs.
• Responsible for obtaining pertinent and accurate information and directing calls to the appropriate individual, department, or source as needed.
• Identifies potential emergency situations and handles appropriately.
• Ability to handle a high volume of calls for appointment scheduling and physician referrals.
• Proficient in the use of all software programs and in meeting customer needs through data collection, analysis, and referral management.
• Respond with best in class customer service techniques to deliver a differentiated customer service experience.
• Demonstrate through knowledge of ProMedica’s employee health plan, and other assigned plans.
• Assists with other duties as assigned.

REQUIRED QUALIFICATIONS

• Education: High School Diploma or GED Required
• Skills: Must have excellent interpersonal skills necessary to communicate effectively with callers, members, physicians, and other providers. Must be willing to achieve goals with team members and engage at the highest level of customer service. Experience using Microsoft Windows and Microsoft Office programs required. Demonstrated typing competency (minimum of 40 wpm). Must possess good organizational and priority setting skills and exercise independent judgment with minimal guidance and supervision.

Additional Experience

• High level of customer service/member focus desired. The ability to engage others to execute, adapt and respond to the needs of the business, look for ways to improve, and provide an exceptional experience for members.

ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio.  For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace