Health Navigator
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Job Description
Health Navigator supporting BlueCross Tennessee members after hospital discharge. Coordinating care, appointments, benefits, and resources to improve health outcomes.
Responsibilities:
- Conduct educational telephone calls advising members of available benefits, services, and programs
- Complete health needs assessments and refer members to population health management programs as appropriate
- Reach out to members with identified gaps in care and encourage compliance
- Assist members in locating providers and scheduling appointments
- Manage system work queues
- Screen members for eligibility, prior case activities, recent claims, customer service inquiries, and authorization history
- Assign members to the clinical team for call outreach and intervention
- Research and analyze inquiries or complaints related to processes, designations, lost incentives, and other program-related matters
- Support Senior Care members transitioning home and navigating healthcare needs
- Explain discharge plans, coordinate follow-up appointments, review medication changes, and connect members with support resources
- Work overtime as needed
Requirements:
- Associates Degree in education, communication, or health related field or equivalent work experience
- 2 years of experience in a customer service support role required
- Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability
- Proficient interpersonal and organizational skills
- Sound decision-making and problem-solving skills
- Ability to work independently and creatively
- Self-motivated and able to manage multiple tasks and set priorities
- Effective time management skills
- Excellent oral and written communication skills
- Knowledge of medical terminology
- Various immunizations and/or associated medical tests may be required
- Digital literacy assessment required
- Ability to work 8:00AM-5:00PM ET and occasional rotating shifts of 9:00AM-6:00PM ET
Benefits:
- Remote role within a collaborative and supportive team environment
- Overtime as needed
- Employee position
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