Job Details

Title: Health Navigator

Location: Remote

Duration: 12 months

Shift: 8:00 am- 5:00 pm

Job Qualifications Education - Associate's degree in, education, communication, or health related field or equivalent workexperience Experience - 2 years - Experience in a customer service support role is required

SkillsCertifications 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

Responsibilities:

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.