Member Experience Navigator

Sanford Health•Sioux Falls, SD

1d•Onsite

About The Position

Sanford Health Plan’s Health Navigator provides high touch, member centered support in navigating the health care system and health resources. A Health Navigator serves as a single point of contact and liaison to help members maximize their benefits and realize the value of being a Sanford Health patient and Sanford Health Plan member.

Requirements

High school diploma or equivalent required
Minimum of three (3) years of customer service or similar position experience required

Nice To Haves

Bachelor’s degree preferred

Responsibilities

Triage and research individual member situations to ensure they receive the best experience and care.
Establish trust and provide support through outreach initiatives including the time during the member's onboarding experience.
Collaborate with different resources when necessary.
Complete follow up after connecting members to resources ensuring their needs are satisfied.
Consult with other members of the member's healthcare team to problem solve and seek advice.
Provide superior customer service that is consistent with policies, Sanford values, quality standards and service commitments.
Serve as initial point of contact between members and Sanford Health Plan by making outbound, welcome calls to members.
Assist members in completing their Health Risk Assessment and connects them with Health Guides, Social Work, and Care Management resources as needed.
Work with providers and facilities to prioritize and schedule appointments.
Consult with and connect members to appropriate departments to assist and provide members with a clear understanding of health care billing transactions.
Comply with established auditing criteria for interactions.
Stay current on policies and procedures to provide accurate information.
Maintain the confidentiality of members' personal information to be compliant with confidentiality policies.
Maintain customer record with proper notation and detailed comments.
Be informed of all Sanford Health Plan products, including covered/not covered services, as well as new plan designs, modifications and documentation updates.
Be informed of Sanford Health resources and connecting points.
Provide seamless transition and transfer as needed to ensure continuation of care and service.
Perform follow-up and regular check-ins with members to ensure they are receiving the best care and experience.
Perform other relevant duties deemed necessary to achieve department and system-wide goals.
Work within defined parameters to identify work expectations and quality standards, but is empowered to prioritize the member's needs, and works under minimal direction.
Maintain a good team rapport with various departments and personnel across the system to resolve member questions.
Demonstrate helpful, friendly, positive attitude and provides the highest level of customer service to each member in a courteous, respectful, and confidential manner.