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Health Navigator
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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
Job Qualifications Education
Associates Degree in, education, communication, or health related field or equivalent work experience
Experience
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.