Personal Health Advocate

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $37 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Health Advocate

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📣 Marketing

Healthcare • Consulting • Marketing

Health Advocate is a company dedicated to making healthcare easier for organizations and their members. Utilizing a combination of personal support, data, and technology, they offer a whole-person approach to improve health outcomes, reduce absenteeism and presenteeism, and lower costs. Their services include health advocacy and navigation, clinical care management, emotional health support, and personalized well-being programs. Health Advocate caters to over 12,500 organizations, offering 24/7 support in over 250 languages and ensuring HIPAA compliance and NCQA certification.

📋 Description

• Receive inbound member calls about healthcare issues including infertility, chronic disease, medications, and diagnoses • Assess member needs and determine appropriate actions while following policies, procedures, and KPIs • Take ownership of member cases and encourage continued engagement • Educate members about medical conditions, diagnostic testing, test results, and treatment options • Explain complex medical and benefit information clearly and compassionately • Build trusted relationships that support member participation in healthcare decisions • Provide healthcare provider and service options based on clinical needs, geography, and benefit coverage • Research providers through credentialing, education verification, and medical-center affiliations • Facilitate communication among members, physicians, and insurance carriers • Assist with appointments, medical-record transfers, access issues, benefit provisions, prescriptions, fee negotiations, and authorization challenges • Maintain accurate and timely case documentation in approved systems • Make outbound follow-up calls and respond to delegate-box, answer-service, and after-hours calls as required • Escalate cases appropriately to supervisors or internal clinical resources • Stay current on patient-care procedures, diagnoses, authorizations, denials, and healthcare practices • Mentor and support new team members • Collaborate with colleagues to maintain service excellence and balanced workflows • Establish professional relationships with internal and external customers • Collaborate with team members to meet departmental goals • Deliver customer service that exceeds expectations • Escalate workflow or communication issues to leadership as appropriate

🎯 Requirements

• BSN or RN degree from an accredited college or university (required) • Active and unrestricted State or Multi-State Registered Nurse license (required) • Minimum 3–5 years of clinical and/or medical management experience • Behavioral and/or mental health experience strongly preferred • Strong understanding of medical terminology and healthcare systems • Excellent verbal communication skills and professional phone presence • Ability to explain complex healthcare topics to diverse populations • Highly effective listening, problem-solving, and issue-resolution skills • Strong organizational and administrative abilities • Proficiency with Microsoft Word and Excel • Ability to work effectively in a collaborative, remote team environment • Ability to work in a fast-paced, high-volume phone environment • Ability to stay organized, document thoroughly and in real time, and follow cases through resolution • Dedicated HIPAA-compliant workspace with reliable internet access • Ability to perform prolonged sitting, continuous computer and phone use, repetitive motion, typing, concentration, reading, and ongoing verbal and written communication

🏖️ Benefits

• Training provided to do the job well • Room to grow and opportunities for promotion from within the company • Fully remote work arrangement • Dedicated HIPAA-compliant workspace requirement • Reasonable accommodations may be made for individuals with disabilities