Health Navigator
Healthcare Services company looking for a Health Navigator to join their dynamic team. As a Health Navigator, you’ll be the frontline of the Commercial Care Team, guiding members through their healthcare journey and making a positive impact on their lives. In this role your primary focus will be on:
- Site of Care Improvement: Ensuring members receive the right care at the right place.
- Readmission Prevention: Providing crucial pre and post-care support to keep members healthy and out of the hospital.
- Pediatric Wellness: Promoting wellness appointments to ensure our youngest members thrive.
Job Responsibilities
- Conducting educational telephone calls advising members of available benefits, services, and programs; completing health needs assessments, and referring members to appropriate health management programs.
- Reaching out to members with identified gaps in care; encouraging compliance and assisting with locating providers and scheduling appointments.
- Managing system work queues; screening members for eligibility, prior case activities, claims, customer service inquiries, and authorization history; assigning members to clinical teams for call outreach and intervention.
- Facilitating research and analysis of inquiries/complaints related to processes, program designations, and other program-related matters.
- Working overtime as needed.
- Immunizations and medical tests may be required.
- Digital literacy assessment required.
Job Qualifications
- Associates Degree in education, communication, health-related field, or equivalent work experience.
- 2+ years in a customer service support role.
- Ability to work independently or in a team environment with shared responsibility.
- Proficient interpersonal and organizational skills.
- Strong decision-making and problem-solving abilities.
- Self-motivated with the ability to manage multiple tasks and prioritize effectively.
- Effective time management and communication skills.
- Knowledge of medical terminology.
- Proficiency in Spanish is not required but is strongly preferred.
