Health Plan Specialist - Kona

HMSA
United States, Hawaii, Kailua-Kona
Mar 11, 2025
CUSTOMER EXPERIENCE -- SERVICE & SALES Provide all customers with an exceptional customer-focused and positive HMSA experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excellence. Use every customer interaction to move the customer along the health continuum in furtherance of HMSA's vision. Seek to understand and resolve the customer's needs, issues, and problems. Know the full suite of their coverage and available services. Use web-based tools, customer-friendly language, and other aids to educate and ensure customers understand their current products, benefits, available tools and how to use them effectively. Analyze and identify the root cause of issues; propose applicable options/solutions; gain acceptance to proceed with an option or solution. Follow through on commitments. Analyze the needs and wants of prospective customers. Use knowledge and expertise of the healthcare industry to determine eligibility. Know the full suite of available and compatible products to conduct product comparisons, prepare proposals, identify the best product solutions including benefits, features, company services, operation processes and how they specifically benefit the customer. Use web-based tools, customer-friendly language, and other aids to effectively communicate, educate, promote, and sell these options to the customer. Follow up on enrollment opportunities. Accurately and efficiently address and respond to incoming requests from customers/prospects. Thoroughly document interactions/inquires within same day. Follow thorough to completion (processed/resolved service inquiry or closed/lost sale) while keeping customer informed of status. Support and promote HMSA well-being and product initiatives. Support, deliver on, and meet HMSA activity standards, sales, service, membership, and customer satisfaction goals. RELATIONSHIPS Serve as the "face of HMSA" to provide HMSA products, select USAble products, well-being resources, and servicing to our small business, individual plan, and Medicare plan customers. Includes representing HMSA at community events. Create a friendly service/sales experience for anyone with questions regarding health care, health insurance, or other related topics. Use broad knowledge of products, services, and changes in the healthcare industry to provide guidance, education, and answers to their questions, and how they're affected, in a way that is simple and easy to understand. Build enduring relationships with HMSA's customers, and other consumers, by becoming their personal trusted advisor, and by effectively delivering on commitments. Use sound judgement to determine appropriateness of referring customers to other areas/persons. Conduct referrals in a friendly and warm fashion. Manage internal and external customer relationships to ensure that customer product and servicing needs are identified and addressed. Coordinate problem solving associated with customer inquiries. TRAINING Meet ongoing training requirements, keep current on product and service knowledge, keep current on HMSA system functionality. Understand the drivers and trends within HMSA and the healthcare industry that affect HMSA's consumers and shape their buying decisions. Be aware of competitive activities and opportunities. Use web-based tools, and other aids, to educate and train customers on effective use of self-service tools and resources. STANDARDS AND COMPLIANCE Comply with internal operational and service standards, all Federal requirements, State requirements, and HMSA compliance requirements. Maintain accurate records of all prospect & customer activity. Provide management with a weekly report on sales opportunities, proposals, jeopardy/lost accounts, sales activities, and servicing issues. Provide input and feedback on corporate policies, processes and procedures, marketing collateral and campaigns to HMSA Center Manager. Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid