[Hiring] Personal Health Advocate @LanguageLine Solutions

Role Description

Your primary accountability as a Personal Health Advocate, Registered Nurse is to deliver high-quality, member-centered clinical advocacy while meeting service, quality, and case management standards. Success in this role includes consistently achieving:

• Member Advocacy & Clinical Guidance
  • Receive inbound member calls related to a wide range of healthcare issues (e.g., infertility, chronic disease, medications, diagnoses).
  • Assess needs and determine the best course of action while adhering to established policies, procedures, and performance indicators (KPIs).
  • Take ownership of member cases by going beyond the initial request and encouraging continued engagement.
• Education, Trust & Relationship-Building
  • Educate members on their medical conditions, diagnostic testing, test results, and available treatment options.
  • Explain complex medical and benefit-related information clearly and compassionately.
  • Build trusted relationships that empower members to actively participate in their healthcare decisions.
• Care Coordination & System Navigation
  • Provide members with options for healthcare providers and services based on clinical needs, geographic location, and benefit coverage.
  • Research providers through credentialing, education verification, and affiliations with recognized medical centers.
  • Facilitate communication between members, treating physicians, and insurance carriers.
  • Assist with scheduling and re-scheduling appointments, transferring medical records, resolving access issues, and clarifying benefit provisions.
  • Intercede on behalf of members to obtain earlier appointments or remove barriers to care.
  • Support members with prescriptions, pre-service fee negotiations, and authorization-related challenges.
• Case Management, Documentation & Follow-Up
  • Maintain accurate, timely documentation using approved case management systems and procedures.
  • Place outbound follow-up calls when issues cannot be resolved during the initial interaction.
  • Respond to delegate box, answer service, and after-hours calls as required.
  • Escalate cases appropriately and on a timely basis to supervisors or internal clinical resources.
• Professional Growth & Team Contribution
  • Stay current on patient care procedures, diagnoses, authorizations, denials, and evolving healthcare practices.
  • Mentor and support new team members as needed.
  • Collaborate with colleagues to maintain service excellence and balanced workflows.

Qualifications

• BSN or RN degree from an accredited college or university (required).
• Active and unrestricted State or Multi-State Registered Nurse license (required).
• Minimum 3–5 years of clinical and/or medical management experience.
• Behavioral and/or mental health experience is strongly preferred, especially experience supporting members through sensitive, complex, or emotionally charged healthcare situations.

Requirements

• Strong understanding of medical terminology and healthcare systems.
• Excellent verbal communication skills and professional phone presence.
• Ability to explain complex healthcare topics to diverse populations.
• Highly effective listening, problem-solving, and issue-resolution skills.
• Strong organizational and administrative abilities.
• Proficiency with Microsoft Word and Excel.
• Ability to work effectively in a collaborative, remote team environment.

Benefits

• This role offers $37 per hour and is for evening hours: 12-8:30 pm EST, 12:30-9 pm EST, 1-9:30 pm EST.

Company Description

Health Advocate is the nation’s leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being.