Job Summary:
The role of the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to members and their families through personalized resource and referral facilitation, issue resolution and healthcare navigation. Utilizing motivational interviewing and guided approaches, the family health advocate will play a critical role in supporting members to achieve their health goals, reduce costs and optimize quality care.
Essential Job Functions:
- Answer inquiries from members (via voice and chat) for the following:
- Help with eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and vision plans
- Provider search (PCP, specialty, and facility), focused on healthcare cost and quality, and present premier provider options, including but not limited to medical, dental, and vision plans
- Support for spending accounts, pharmacy, and disability.
- Assistance with incentives and rewards
- Aid with ordering durable medical equipment (DME)
- Community resource search
- Member preferences management
- Coordinate issue resolution with providers, payers or 3rd parties for:
- Claims adjustments
- Qualifications:
- High school / GED diploma
- 2-yr associates degree in healthcare/health sciences OR equivalent experience in healthcare, preferably helping members navigate benefits and claims, OR held one or more of the following positions:
- Health Guide/Advocate/Navigator
- Medical Assistant
- Pharmacy Technician
- Phlebotomy Technician
- Electrocardiograph (EKG) Technician
- Patient Care Technician (PCT)