customer service representative

member services representative

senior application developer

technical support

mailroom clerk

Healthfirst (New York)

For those of you considering call center jobs at a health insurance company consider this — *some info specifically applies to the specific company I work at*

If you thought that this remote job would be easy, let me tell you that downtime really depends on call volume. On super busy days it’s back to back calls and it can be overwhelming at first but you get used to it slowly. Your pace gets a bit quicker but it depends on the types of calls you get too. You’ll start to understand what the answer is / how to document the calls as the time goes on. However, insurance changes every day and the policies change everyday so you can’t get too comfortable. 

Training is important — this current company I’m at provided some training but it wasn’t enough — mind you, I had 4 weeks of training. You learn more during the calls because the training can be a bit basic and all the information doesn’t come together until you’re applying it. Even after training, there’s a big learning curve because there are different points we have to hit during the call. 

During training we learn about the different programs we have to use (there’s a lot ~7 websites and ~6 software programs), and the insurance plans we have, and different departments that relate to our job and also where we might end up moving to. 

The job itself, personally, is good if you like puzzles and piecing things together (because you literally need to search for the answers) 

You have to have Empathy for your members and be able to understand what it is that they’re asking and be able to search for the answer in the thousands of job aids that we have. Job aids are good but some things need to be asked from the senior agent and even then, some know the answer some don’t. It really depends on experiences. If you’ve ever had an experience where you thought you received help, but it was wrong? It’s likely because the service agent used incorrect information and this happens all the time because of miscommunication and how complicated all the processes are.
—————— Example: Member wants a DME (Durable Medical Equipment) — we have to call provider for Rx and a letter of medical necessity to get faxed to our company — and submit a request for the DME that you want, but you won’t get it immediately because once that gets faxed, it needs to get uploaded to your account (another department does this) and then another department authorizes your DME order request (or rejects it). Once authorized, the order then gets passed to another Vendor associated with the insurance company who THEN disperses the orders to local vendors/pharmacies to provide/deliver the DME to the member. Yes, there are lots of moving pieces and sometimes agents aren’t taught this until you learn by being on the call and putting the pieces together. 

This is just one of the many things you’d have to do — yes, there are easier tasks such as changing Primary Care Physicians or replacing ID cards, but then there are more complicated problems that we need to solve and if we can’t find the answer quickly, you’ll have to wait on the phone. Believe me, if you’re put on hold, the service agent is looking for the answer. 

People will get angry but you can’t curse back or hang up the phone. You’ll automatically fail your call if you do. This is a customer service job after all. 

Honestly, it feels a little bit disorganized and I’m relying more on my teammates than other people and that include because senior agents because some don’t know what they’re talking about. There are a few that are good and those are the ones to reach out to. 

They grade you on everything and monitor what you do on the computer 
— your calls are audited and graded (10 calls a month, but you’ll answer around 200 calls a month — roughly 10 calls a day but it could definitely be more and depending on how long each call takes, it can be a smaller amount too).
— how much time you spent on the call 
— how many calls you take 
— how much time you spend on “after call work” which is when you’re documenting your call and writing about what the call was about, what solutions you gave, etc
— they are very big on adherence to the schedule// we receive a schedule and each day it might be a little bit different so if your break is at 10:45 and you take a break at 11 o’clock because you’re on a call from 10:30-11am, your adherence grade goes down. 
— while taking calls, don’t send inappropriate messages to your teammate , you’ll get points docked off and the auditing team can see everything you do on your computer. 

Thought high school pop quizzes were over? Not here. There are monthly quizzes regarding certain topics to make sure we know our stuff. 

This place is strict and not accommodating for people with kids from what I’ve seen with my coworkers. Definitely make sure you do your homework on how accommodating the company /department is for people that need to be a caretaker. Within the same company, different departments will be more or less accommodating with your personal needs. The contact center operations department definitely puts itself higher than your family and kids though — although they want to say otherwise. Perhaps it’s just this particular department at this particular company though. Again, do your research. 

The team lead / manager is really going to affect what the flow is like and how much help you get. They are either going to be there for you and advocate for you, but remember they need to protect their jobs too. 

If you are interested in this sort of job, definitely try to negotiate your pay at the beginning because once you accept your job, you can’t negotiate until the end of year assessment — at least not at this company. They will try to pay you as little as possible (are we surprised though?) There are bonuses for people who do very well and meet high expectations of the departments criteria. 

I’m being told there’s a lot of room for growth but we’ll see about that. If I could, I’d def transfer. If you’re good at your job then you have the chance to get promoted in six months or move to a different department after a year at this department. 

You get 19 PTO but that includes sick time too. 10 days roll over to the next. 

PTO and Shift bids also occur but the better job you do the higher chances you get of being able to get PTO and choosing better shifts. If you don’t care about shift hours then it doesn’t really matter. For Open Enrollment, you have to be prepared for a shift anytime between 8am - 8pm!

You can’t use PTO Until 90 days but if you speak about any pre-scheduled events during the interview, you will get approved but they will have you use PTO.


I was so excited for this position because of the mission statement of the company, and how it was stated that I would be helping people in a meaningful way.  The company often reiterates that they are not-for-profit and their members are "their northstars".  It didnt hurt that the salary they offered for this position was well above industry standard for this type of role. 
   It was a bait and switch.    The only thing that matters monthly are your metrics.  
-Average caseload for CMs is 120-140 members, and the expectation is that you make "successful" contact with 85% or more of them monthly. This could be in the form of simple check-ins (which are often not simple and can take 30-60min)  or to do lengthy (1hr or longer) care planning assessment calls.  Daily, you are expected to do 8-10 completed calls and 1-2 care plans.  With a 7.5 hr workday, that doesnt even add up.  
-Your documentation is randomly audited, and you are "graded" on it.  A minimum pass is 95%.  Your calls are also recorded and randomly audited.  
-New CMs have a caseload of mostly new members, so all are due for care plans at the same time. These care plans take a total of 2-3 hrs to prep, call and write up.  It is not unusual to have 20-25 care plans due a month, on top of your regular outreaches.  
-There are also lengthy assessments due each time a member is hospitalized, goes to the ER, and other random assessments that get triggered by the system.  When asking direct and middle management for assistance with learning how to triage which assessments need to take priority, you are told they are all priorities.   
-You also have to field incoming calls from members through CST, who often simply transfer calls to CMs to handle if they cant/dont want to, even if it is an issue within their scope.  The CST positions are outsourced to another country, and sometimes there is an evident language barrier. 
- You  must read and respond to interdepartmental emails in a timely fashion all throughout the day.   Some of these issues require time to resolve, which is time away from calls. 
- If a member is transferred to you, any overdue tasks not completed by previous CM simply get transferred to your name.   There are a massive number of tasks that need to be handled in very specific ways, and no training is given on what to do with those tasks.  You are expected to look it up or figure it out on your own, but do it correctly, and not spend too much time completing it. 
- As a new CM, your caseload trickles in over a couple of months, randomly.  You may be on track to make your numbers for the month, and then get slammed with a batch of new members, sending your percentages back down to rock bottom.  If, at the end of the month,  you fall below 85% completed outreaches, you are disciplined, regardless of when in the month the members were assigned.  
-Time spent on long calls does not matter.  Unsuccessful calls (where you made adequate attempts and people just did not answer) also do not count towards your numbers.    Outgoing calls to vendors do not count.  Extra attempts to reach members do not count.  You can spend an entire day on the phone, and unless you completed 8-10 outreaches, its assumed you did nothing at all.   
-There is an hour long Zoom staff meeting at least once a week, sometimes more.
 - You are monitored on the phone lines and need to change your status every time you do something, like get up to use the bathroom, or take an incoming call.  The time spent on calls, the number of calls, the time on each call, are all monitored and you are expected to reach a certain percentage of your time on the phone.    
-  Many members are not English speaking and there are inadequate translation services available.  You often wait on hold for a translator for 15-20 min, or none are available at all. 
- You are expected to hunt people down to be able to talk to them- calling family, emergency contacts, numbers listed on old forms,  vendors and doctor's offices to get contact.  None of this extra time applies to meeting your metrics. 
  -The members and the staff are just numbers.  There is absolutely nothing human about this position.  We are expected to be robots.  When you are asked what your roadblocks to "success" are, you are told those issues arent real, and you just arent trying hard enough and are bad at time management.  (Nurses know how to time manage, its almost a pre-req!)  I understand that it is corporate and the only way they know that their employees are "working" in remote positions may be the metrics, but we are licensed professionals, treated like untrustworthy children.  The micromanagement is UNREAL.  If your numbers arent on track for the week, or even the day, you get emails and Teams messages "did you do x?" "Did you do y?" ",Have you tried z?"  Any time you do reach out for guidance you are given rudimentary, trite and useless advice about time management, that isnt applicable to the actual work.   It is assumed that you have made zero effort. 
-There is constant talk about lessesning caseloads for CMs, but apparently has been for years.  The growth of the company and influx of members far outpaces hiring and retention of CMs, so case loads just stay high. 
-The first month of work is CTAC, or computer training, and while the instructors are great, it taught you nothing for your role.  You are then tossed into the position with a preceptor for a month, who still has their own caseload to manage while orienting.  (Preceptors are also stressed because they still have to make metrics even while precepting.).  Month 3 you get your own caseload.  
-There is zero work life balance.   I literally changed my and my family's lives around for this position and it has taken over.  I fall asleep and wake up stressed every Sunday-Friday.   The orientation process feels like hazing.  We are all told that the first months are the hardest and it takes 6mo- a year to settle in and be comfortable in the position.  Later, you get told that it doesnt change, and these are just the expectations, and this is how the job is. 
  TL;DR?  Run, run, run.  Bait and switch.  

A typical day at healthfirst is showing up on time because managers and auditors make sure you are where you say you are. But there is relatively a lot of freedom. Unfortunately thier market is catered more to a medicaid/medicare market meaning your not working in the best of neighborhoods. You might get a lucky break and find a nice place to work out of, but it is generally hard since you are competing with other people within your team and other plans, hopitals and clinics and doctors offices see a million of you everyday, and generally if someone has a good spot they will not give it up ever.. I like helping people but like most plans ENROLLMENTS is the name of the game. Some managers are awful but some are nice. Healthfirst is like a giant ship with the giant oars and no wind. the Head honchos beat the drum, So The CEO tells the VP of Sales we need more enrollments, the VP tells the District manager, the District manager tells the Manager and subsiquently that pressure falls on the reps. If they want you gone you will be. But produce and all will be well. This job is 85% hardwork 15% luck sometimes its just being at the right place at the right time. And knowing the rules. covering yourself is law here. Co-workers arent bad. Dont trust everyone though. people will smile in your face and take enrollments from you. Its excused because it is the nature of sales. Management reminds you how bad it is not getting enrollments. Management sends out emails how they let some one go for whatever. kind of letting you know that you can be next. The hardest part of the job is the Stress of not having enrollments and little upward movement, and little to no job security as well as all you are is a number. I have literally went to a team meeting and you hold up a number of your projection like that is all your worth. But as sales people that is the life we chose so it is accepted. to get a promotion you have to have high or decent numbers, they rarely higher from within always bringing on new people from different plans. and if they do 5-8 yrs of service bearing the cold, heat and stress is typically asked of you. Unless your lucky to have a hospital spot (Usually filled by people who have been there for years and will wither up there) or are answering phone calls (same pretence applies) leads .. you might get one, two, or three a month tops. you need to have at least 16 enrollments a month to be left alone , but 21 is goal. out of 100 reps there are 6-7 stars then everyone else is normal then the bottom people. if your one of those people you will be hassled and constantly reminded you are under goal. Stars are embraced and under performers are not . Granted another month of employment out of pity, or maybe hope that you will do better next month. They have coaching lessons where they say whatever you need they can help you with . but in reality it is all on you. they cant help you. You need to figure it out. find that one connection to the wonderful land of old people who have that magical red white and blue card. pro is the money. A little bit of work goes a long way. an enrollment takes 20-30 minutes tops and one a day and you will be fine. you can sit all day work for 30 min. and be the best employee ever. (In theory) sometimes it rains applications other times its a tough drought. Not challenging at all a monkey could do this job and will prob get more enrollments than you your first couple of months. but all in all it pays the bills and it is an easy job if you have applications. If you dont be prepared for the worst.

I have worked for Healthfirst for 6 years. The culture for Healthfirst in Lake Mary Florida is extremely poor. There are a few Managers placed to lead, whom are more concern about their image as a manager rather than leading or giving direction for an employee to pursue growth. Never mention you are studying in college so you can pursue growth with the company, there are some jealous leaders (seniors/supervisors) who will try to block you in moving forward ahead, this is based off experience. The sad thing about this place is, you cannot speak up to have these things known. Everyone who has, has been fired.
 If you have a Senior or Supervisor that holds animosity towards you, they will speak to upper management about you being a horrible employee, they then make your work environment extremely uncomfortable to work in. If one complains to HR about their senior/managers dishonesty, they will make you look incompetent, to the point where you are discharge for poor performance, they will make the environment difficult to work in, it will get to the point where an employee wants to quit. The sad part about it, this is all personal nothing to do with work or performance.
I have seen this many times before, in six years two different departments I have worked. Unfortunately, I was one of them that experienced this. I have experience being lied on, when I explained that task given, I was not given a job aid, but told to use google. (TRUE STORY). The work I have done in the past year was never documented or accounted; my supervisor made it look like I was using other work to complete my own. I could not defend myself. I got so bad there were night I never went to sleep, because of the fear, I was experiencing. There was a time the senior was on vacation and the Sr manager was filling in for her. I text both the manager and senior to let them know I was extremely Ill and could not drive to work. The manager never responded, but while on vacation the Senior text back to say. Okay feel better, I came in the next day. The manager said I did a no call no show. The senior told him she got my message. He said he never received it cause the company phone cannot not do a group text. That was a bold face lie.
The Managers in Florida can hand pick employees from other departments without going through an initial screening process.
The workload can be unbearable, Managers make it difficult to complete task forcing to work off the clock hours. When this is brought to their attention, it is said that working unpaid hours is a Choice. This was brought to Human resources attention. Nothing was done about it. I am seeking legal action for this. I’ve went to HR to complain about the Anxiety that the Manager and Senior was placing on , because of the outrageous projects, meeting and reports that had to be done. With no overtime. I overheard the managers lying about my work ethics to HR after I complained.  If you decide to work for this company. Know that you will grow tired and weary, not because of the type of work but because of the Managers that are hired to lead. When I was hired, I was underpaid and over worked.  Also know that there is no Job security here only for the big bosses.

I worked as a Clinical Educator for the Intake Department.  I have been in nursing for 30 years and this was the poorest managed, most unpleasant and disorganized company I have ever experienced.  From the first day that I was there I experienced an almost comical (looking back) series of events.  I endured (not exaggeration) a classroom orientation during which I did not have access to my office computer, cellphone or scanner -- they did not work --and I was told day after day that someone "has been notified and will put you in the system, so meanwhile just follow along and listen". I sat for a week.  I emailed my Assistant Director to see if she could help, but she never replied --- never even ventured up two flights of stairs to welcome me.  This was a sign.

 When I began work in my department my Assistant Director barely acknowledged me, my "preceptor" repeatedly fell asleep while training me - sometimes in mid-sentence, shared very personal and embarassing information with me from the day we met, and displayed erratic behavior fluctuating between angry outbursts, overzealous laughter and sleep.  I reported this to my Assistant Director (who had witnessed weeks of this from her desk 3 feet away and said nothing) and she meakly apologized saying that she was sorry that "your orientation has had to be this way" and then did absolutely nothing.  My preceptor then began to ask me to perform tasks in very specific ways which seemed questionable but she would assure me that "this is the way it must be done".  When I would complete the task, the boss would correct me, telling me that this is not the way it should be done and my preceptor would state "oh I know, I would have done it the other way".  When I reported this to the boss, she again said "I'm sorry it has had to be this way.  I'm glad you are telling me this.  I'm surprised that you didn't walk out the first week. A lot of people would have." 

My suspicions that something was seriously amiss with my preceptor were soon verified and she suddenly left on a Medical Leave never to return.  I was left to train myself.  My office team members were young, dissatisfied and arguing among themselves.  I was presented with written goals for the year that were utterly unrealistic and pointless.  The Assistant Director would rarely acknowledge my presence but on the few times that she did her demeanor was condescending.  She made little eye contact and was socially awkward and rude.  She seemed to feel that she was an expert at all jobs and would instruct me as to how to plan my presentations down to the most minute detail. I had to wonder why I had been hired.  A word of praise or thanks was never uttered.

I left after 8 months. I will never forget the experience.  The office that looked like a circus with dissatisfied employees endlessly grumbling, the mismanagement and lack of leadership.  Truly an awful experience.

First: HF needs to hire professional employees that know the basics on interviewing someone. Maybe 1 out of 10 are good interviewers. Out of 5 interviews I had with HF I could say two of them went right to the point, the questions asked were based on the job descriptions and resume submitted. The other two I believe did not even read the resume and the questions asked were not really related to the job description, I think they got them off google. Also, some interviewers were not professional at all, I don't know how they even became interviewers.  So once you get a position it's really hard to advance to another position. Some wait more that 4 years to finally get something new within the company.  Others never get the opportunity to move up so they quit and others were fired after 5 years with the company because their pay became to much and they were let go to hire new people with less pay.  This happens a lot within the company.  But then again others move up because they know someone high up and they were hired before being interviewed, even if they are not a great fit for the job. This brings me to my next comment.

Second: Management sucks in practically all departments, at first they are great until they show their true selves. They will micromanage your work. They want you to work double or triple on top of the work you already have and cover other employees that go on vacation, quit, get fired or call out that day, but they don't want to pay you enough to accomplish everything they ask for.  Also, some have nasty attitudes, so don't disagree with a bad score you got from your audit.  I submitted a complaint with HR for bad treatment with a supervisor with a new manager that came in to the department and nothing happened and then I found out she was let go and the supervisor was then promoted to a manager. Really bad management !!!!  Some don't follow their own rules and they change them to meet "department needs" at any time.  Everything is always business needs never mind employee needs.  Believe me they will have someone else train you, so if you get a job in HF write down everything and make a lot of notes, because the Supervisors, Managers and Directors will always second guess you and you will know more than they will, so be confident and stand by your skills. They don't know your job and has never worked on the job skills you have. So if they don't like it they will change it to meet their needs and train you all over again. Believe this!!!!!!


Toxic!! They make it difficult to keep the "care" in "care management". More work faster, people treated like robots. So many meetings and trainings it is difficult to actually get work done.
One of their cultural drivers is "Break Down the Walls" but I have never been at a more siloed organization. Very difficult to track down who does what. Good luck getting someone to answer any questions.
Managers are "encouraged" to "coach" for overall development but in reality are forced to focus on "productivity". Performance reviews are forced into a bell curve. 
There is a lot of favoritism. Finger-pointing is rampant. People will throw each other under the bus without a second thought at all levels. If they want someone out, they will carefully manipulate your failure but they know how to legally cover themselves.
For a while a favorite saying there was "Don't let perfection be the enemy of good" - yet they expect perfection. Mistakes (real or not) are not teachable moments, they are death warrants. Be prepared to hear the word "ding" a lot. You'll get “dinged” plenty, and if you're in management you'll be “dinging” your staff.  Management is a tough position to be in – you’re subject to being mistreated by people above you and forced to work with your staff in a way you might not feel comfortable with. 
High turnover from people leaving and being let go. Too many people constantly nervous about whether or not (or simply when) they'll be fired. Just not a psychologically or emotionally healthy environment.
That said – if you are a nurse you are more likely to be looked on favorably.  And if you are one of the lucky ones the actually want to support, you might do well.


Proper Training is abysmal and almost non existent. Before you even fully learn the line of business you were hired for, they already throw you into another training for another super complex line of business. They put you back on the floor before you're ready and sometimes the training is 1 day to 2 weeks, depending on what it is.  They never ask if you're comfortable learning something else, they just force it on you and say it's mandatory in order to "better assist the members"(Lies) and constantly tell us on a daily basis that we're replaceable and how we're lucky to have a job. At the end of the day, all they care about is increasing their revenue stream. 

They don't even pay you for the extra lines of business that you learn (or attempt to learn with their terrible training). We should get paid more for the additional stress we take on. The hardest part of the job is the systems and policies and not knowing every little thing in order to assist the members. There are a million policies and every time you ask for assistance, you get 6 different answers from either the same people or different people, it doesn't matter. Policies change literally 10-20 times a day and you're expected to keep up with each and every single one. You just have to figure it out yourself at the end of the day. 

Workplace culture is way too stuffy and you feel like you can't breathe or be a real person there. Management says they won't micromanage you but they always do right off the bat. Micromanagement is Healthfirst's middle name. Last name is Perfect Metrics.

Metrics are too much. They want you to get perfect metrics on every single call and they make it very easy to fail your call. They don't care that we're human and humans make mistakes, not at this job they're not allowed to. They really should just make the IVR system take all the calls and just get rid of everybody because a robot is the only thing that can keep up with their ridiculous demands for perfect metrics and their micromanagement.  

TL;DR: DON'T WORK HERE. STAY AWAY FROM THIS HORRIBLE PLACE.

I was happy to start a remote job last year but it hasn’t really been all that they have made it seem. Calls can be really stressful sometimes back to back to back where a sip of water seems to be bad. They only care about the team numbers and having agents meet percentages on adherence and how long you take on a call and etc. If you miss a break they guilt trip you into thinking “should I take my well deserved and lawful break? Or should I skip a break and keep working to keep my adherence percentage up to standards?”. If you take breaks during the day for bathroom they ask you if you need an accommodation, the answer is no, sometimes you just need to go it’s as simple as that. Another thing wrong with this company is the lack of communication they have. They tell you one thing then tell you another and then tell you that you’re wrong even though it’s what they told you and then they tell you another. There should be CLEAR communication so that we know what we are getting ourselves into. This company’s goal is to have service agents learn every line of business eventually when there should be a clear set of division between lines of businesses. I feel this way because I would know being that they give you opportunity to take trainings in other lines of businesses and they tell you that you’ll only be taking calls for that, but then switch up and have you taking calls for 3 different lines at the same time which is very confusing and annoying being that you need to hit different talking points on calls. Sometimes this job feels more like school than work, they have you do so many assignments and things due. Had one employee tried to call me a liar and another try to be rude. You need to be one to speak up for yourself if not they will walk all over you. Management is also so fake, if you try to express how you’re feeling in team meetings then they claim it’s “emotional outbursts” and try to make it a joke. 

Healthfirst is a great place for entry level positions. There are a number of skills you can acquire in an analyst or entry level position and there are quite a number of systems to get familiar with if you enjoy working with process mapping and data types.

I have personally grown from 10+ years in Healthfirst, but I have regrets for staying as long as I did.

The hardest part of my job is working with difficult Managers and Executives. Our HR Department is not the easiest to work with, or the brightest and many times, employees are not treated with respect nor valued for what they bring to the table.

There are also a number of "cliques" within the Executive level and an attempt to "fit in". 

HR protects anyone with a Manager title or above.If a Manager is difficult, is micro-managing and is setting you up for failure, almost 99% of the time, HR will side with the Manager, e.g. if a Manager submits a case against an employee (lower ranked), and is an irrelevant case, the Employee will have no rights and no fight.

Management wants us to Break Down the Walls and Speak up with Pride, but almost always they do not value our opinions.

Promotions and Employee Evaluations are rolled out on a curve, employees are rated based on favoritism and not on true performance, so every year, good people are forced out due to the imbalance in talent recognition.

Employment is "At Will" which means the employer has the right to terminate the employee at any time with or without cause and for any reason.

I can recommend Healthfirst as a good place to start, or a good place to transfer to, for a short term. But unless you are climbing the ladder within 2-3 years due to having a good boss who recognizes your hard work, diligence and skill, I would suggest moving on to something better, if your goal is career advancement.

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