Health Navigator 189916

Fully remote within US

Job Profile Summary:
Supports area clinical team and serves as a proactive resource for members related to disease prevention and benefit education. Job

Responsibilities:

• Conducting educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
• Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
• Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
• Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries.
• Work overtime as needed
• Various immunizations and/or associated medical tests may be required

Education

• Associates Degree in, education, communication, or health related field or equivalent work experience

Experience

• 2 years - Experience in a customer service support role is required

Skills\Certifications

• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Proficient interpersonal and organizational skills 
• Independent, Sound decision-making and problem-solving skills 
• Must be able to work in an independent and creative manner. 
• Self-motivated and able to manage multiple tasks and set priorities.
• Effective time management skills
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Knowledge in Medical terminology