Care Navigator

Oxbridge Health • Norwalk, CT

21h • $30 - $33

About The Position

The Care Navigator helps members understand and effectively use their Episode Advantage benefits. The role requires knowledge of insurance terminology and strong communication skills, as well as empathy, patience, and problem-solving abilities to support members throughout their healthcare journey. The Care Navigator assists members with benefit questions, portal navigation, complaints, and identifying appropriate episodes of care and care groups with guaranteed pricing. The role also provides clinical guidance and information to members.

Requirements

• Knowledge of healthcare benefit plans and insurance terminology.
• Excellent communication and interpersonal skills.
• Empathy, patience, and strong problem-solving abilities.
• Ability to manage tasks efficiently and maintain organized workflows.
• Proficiency navigating digital tools and member portals.

Nice To Haves

• Customer service experience, particularly in a healthcare setting.
• Clinical knowledge, including medical terminology and treatment plans.
• Fluency in Spanish.

Responsibilities

• Help members understand and maximize their Episode Advantage benefits.
• Respond to member inquiries by phone, email, or chat with clear and accurate information.
• Initiate outbound communications to help members use their benefits.
• Explain covered services, benefit allowances, eligibility, co-payments, deductibles, limitations, and exclusions.
• Guide members through relevant Episode Advantage features in the member portal.
• Handle and escalate member complaints and work toward timely, satisfactory resolution.
• Help members search for episodes of care and corresponding care groups and guaranteed pricing.
• Explain the value of selecting an appropriate site of care and care group for a member’s needs.
• Provide clinical guidance and information to members.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed