Health Navigator

BlueCross BlueShield of TennesseeChattanooga, TN
2dRemote

About The Position

Are you passionate about making a difference in healthcare? We’re looking for a Health Navigator to join our dynamic team. As a Health Navigator, you’ll be guiding members through their healthcare journey and making a positive impact on their lives. In this role your primary focus will be on: Health Risk Improvement: Ensuring members receive the right care at the right time and place. Readmission Prevention: Providing needed support to keep members healthy and out of the hospital. Wellness Support: Encouraging wellness care, appointment assistance and resources aimed to impact healthy outcomes. Benefits Awareness: Educating members about their coverage in an effort to maximize appropriate use of their benefits. Preferred candidates will have experience in medical front office operations, and case management. Multilingual skills are also highly valued. Internal candidates with a performance review rating of 3.7 or higher are highly preferred The hours for this position are flexible with options of either 9:00am - 6:00pm EST, 9:30am - 6:30pm EST or 10:00am- 7:00pm EST. The late shift (from 10:00am – 7:00pm EST) is also rotated throughout the year, this shift is in one week increments.

Requirements

  • Associates Degree in, education, communication, or health related field or equivalent work experience
  • 2 years - Experience in a customer service support role is required
  • Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
  • Proficient interpersonal and organizational skills
  • Independent, Sound decision-making and problem-solving skills
  • Must be able to work in an independent and creative manner.
  • Self-motivated and able to manage multiple tasks and set priorities.
  • Effective time management skills
  • Excellent oral and written communication skills
  • Strong interpersonal and organizational skills
  • Knowledge in Medical terminology

Nice To Haves

  • experience in medical front office operations
  • case management
  • Multilingual skills
  • Internal candidates with a performance review rating of 3.7 or higher

Responsibilities

  • Conducting educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
  • Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
  • Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
  • Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries.
  • Work overtime as needed
  • Various immunizations and/or associated medical tests may be required for this position.
  • This job requires digital literacy assessment.
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