CDPHP and its family of companies are mission-driven organizations that support the health and well-being of our customers and the communities we are proud to serve. CDPHP was founded in Albany in 1984 as a physician-guided not-for-profit, and currently offers health plans in 29 counties in New York state. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The Healthcare Advocate is responsible for delivering a differentiating level of service to our various constituents (Member, Groups, and Brokers). They will support these constituents in a variety of settings including hospitals, employer sites, and CDPHP-designated retail sites. In this role, the Advocate will lead the direct support of our members through the various stages of their healthcare journey. The Healthcare Advocate will partner with CDPHP clinical resources to assist our members in navigating the healthcare landscape. This role will be expected to provide a high level of personalized support to each patient, while also serving as a liaison for patients and their families to ensure access to appropriate resources and services. The advocate will work with members and families to ensure they understand and utilize their benefits, in addition to assisting with scheduling follow up appointments, obtaining required authorizations, and understanding the financial responsibility associated with each service. The advocate will work very closely with all departments to resolve inquiries according to CDPHP’s high standard of service.

The Healthcare Advocate will assist with enrollment efforts during the Medicare Annual Election Period and the NYS Health Benefits Exchange Annual Enrollment Period as needed. If the Advocate is not already licensed, he/she must secure licensing within the first six months of assuming the role. They are responsible to provide concierge service to our members, groups and brokers assisting them in any way needed including but not limited to; sales, benefit questions, enrollment and claims issues.

QUALIFICATIONS:

• High school diploma or GED required. Associates degree preferred.

• Minimum nine months customer service experience in a health insurance organization or health related industry is required, two (2) years preferred.

• NYS Life, Accident and Health Insurance License required or secured after six (6) months of hire.

• Excellent verbal and written skills are required. Experience working face-to-face with CDPHP internal departments and external customers is preferred.

• Working knowledge of all lines of business required (including Health Funding Accounts.)

• Must obtain and maintain Life Accident Health (LAH) licensure, Individual and SHOP certifications and any other NYS requirement in order to sell health insurance.

• Excellent interpersonal skills with demonstrated ability to establish quality customer service relationships and influence at all levels of the organization required.

• Demonstrated ability to determine, analyze and independently solve problems related to claims adjudication and adjustment requests required. Ability to successfully apply problem solving and time management methodology and balance multiple tasks as business needs arise required.

• Must be able to make independent decisions and know when to escalate issues appropriately.

• Ability to work alternative schedule as needed.

• Proficiency in Microsoft Word, Excel, Outlook and PowerPoint is required. Prior facets experience required.

• Working knowledge and experience interacting with Membership and Billing, Marketing, Claims Management, Provider Services, Configuration, and Finance departments in a health insurance environment preferred.

• Strong attention to detail and ability to meet established quality and production standards while maintaining department turnaround timeframes.

• Demonstrated ability to manage multiple tasks, priorities and projects is required

• Flexibility to adapt to a changing and fast-paced environment is required

• Ability to interpret all CDPHP’s health plan contract language, riders, schedules, policies and procedures with adherence to department turnaround timeframes to insure regulatory compliance.

CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.

CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits here (https://www.cdphp.com/about-us/jobs/benefits) .

As an Equal Opportunity / Affirmative Action Employer, CDPHP does not discriminate in employment practices on the basis of race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

CDPHP and its family of companies include subsidiaries Acuitas Health LLC, Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRX Services, LLC.