[Hiring] Allied Care Navigator @Allied Benefit Systems

Role Description

The Allied Care Navigator is responsible for providing concierge-level support to members through their care journey, assisting with finding a curated list of high-quality, low-cost specialists in their network. They have a comprehensive understanding of member’s medical plan, employer point solutions available, assist with scheduling appointments, and providing ongoing assistance. They utilize their past industry experience and critical thinking in a collaborative process to review and facilitate appropriate health services and benefits for members.

Essential Functions

• An extensive understanding of medical plan documents, member advocacy, and cost containment programs, and employer point solutions available to assist members with understanding their covered benefits and financial responsibility for services.
• Maintain a professional and empathetic demeanor while being responsive to member inquiries to prevent delays in care.
• Ability to communicate effectively both verbally and in writing to all parties involved in the member’s referral process; ensuring coordination of care is conducted and ongoing support is provided through the confirmation of services being performed.
• Utilize best in class web-based tools to research high-quality and cost-effective providers in the member's network, maximizing their benefits and providing a curated list.
• Independently manage daily tasks within internal systems within assigned turnaround times. Tasks include, but are not limited to, responses to inquiries made by members and providers and confirmation of appointment attendance and scheduling.
• Document potential impact and savings following appointment confirmation to ensure accurate reporting of the value of the service provided.
• Collaborate with internal and external partners to coordinate member care, document updates in appropriate systems, and update ongoing impacts.
• Develop and maintain written operational procedures for all tasks performed and cross train to provide effective support to all team members.
• Strategize with Medical Management Leadership to discuss trends identified related to member cases.
• Other duties as assigned.

Qualifications

• Bachelor's degree or equivalent work experience required.
• 2+ years of experience in member advocacy or care coordination.
• Working knowledge of employee medical benefit plans.
• Experience with Group health insurance and self-funded health plans preferred.
• Highly skilled in written and verbal communication.
• Intermediate level work experience with Microsoft Office suite of products.

Requirements

• Accountability
• Communication
• Customer Service Orientation
• Functional/Technical Skills
• Quality Focus
• Time and Task Management

Physical Demands

• This is a standard desk role requiring extended sitting and computer work.

Work Environment

• Remote

Benefits

• Competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance.
• Generous Paid Time Off.
• Tuition Reimbursement.
• EAP.
• Technology Stipend.