Health Navigator

BlueCross BlueShield of Tennessee•Chattanooga, TN

1d•Remote

About The Position

We are hiring a Health Navigator at BCBST! In this role, you will support the BlueCare Plus Clinical Support team by serving as a key point of contact for members, helping them navigate their healthcare needs with compassion and confidence. You’ll assist members by answering questions, completing Health Risk Assessments, and ensuring timely support through both phone interactions and administrative responsibilities. You will play an important role in improving the member experience by responding to inquiries through a dedicated phone line, addressing a variety of needs with empathy, and helping members access the services and care they need. Your work will directly contribute to smoother coordination of care and stronger member engagement. To be successful in this role, you’ll bring strong communication skills, patience, and the ability to work independently in a remote environment. Ideal candidates will have at least one year of experience in a medical office setting or working with senior populations, along with knowledge of medical terminology. 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. Note: This is a remote role within a collaborative and supportive team environment Schedule: Rotating shifts of 8:00–4:30 p.m., 8:30–5:00 p.m., and 9:00–5:30 p.m. EST, with occasional coverage until 6:00 p.m. as needed

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
This job requires digital literacy assessment.

Nice To Haves

at least one year of experience in a medical office setting or 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