Health Navigator

BlueCross BlueShield of Tennessee•Chattanooga, TN

5d•Remote

About The Position

We are hiring a Health Navigator at BCBST! In this role, you will support our Senior Care team by serving as a key resource for members as they transition home and navigate their healthcare needs. You’ll help members understand discharge plans, coordinate follow-up appointments, review medication changes, and ensure they have the support and resources needed to successfully manage their health after leaving a healthcare facility. You will play an important role in improving the member experience by providing guidance, answering questions, and helping members overcome barriers to care. Through compassionate communication and proactive support, you’ll help ensure members receive the services and care they need while promoting positive health outcomes and a smooth transition back home. To be successful in this role, you'll bring strong communication and problem-solving skills, the ability to work independently, and a passion for helping others. Ideal candidates will have experience in customer service, a medical office setting, or working with senior populations, along with a solid understanding of medical terminology and healthcare processes. Patience, empathy, and a member-focused mindset are essential for success in this position. We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work, guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.

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 customer service
experience in a medical office setting
experience working with senior populations

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