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Personal Health Advocate
Health AdvocatePersonal Health Advocate at Health Advocate supporting and guiding members through healthcare complexities. Managing a diverse range of healthcare issues and facilitating access to necessary services and resources.
About the role
Key responsibilities & impact- Receive calls from members in regards to various healthcare issues (e.g., infertility, disease, medication, etc.) and determine best course of action/s to assist the members while adhering to established policies, procedures, and key performance indicators (KPIs)
- Build relationships with members in order to collaborate and develop plans of action by going above and beyond members’ initial requests
- Assist and educate members in understanding their medical conditions, associated health testing, test result interpretation, and health options available to them
- Provide members choices in medical care providers and services based on the members’ clinical needs, geographic locations and available benefit offerings
- Research providers through credentialing, education checks and affiliations with notable medical centers within the member’s plan
- Facilitate communication among members, treating physicians, and insurance carriers
- Document cases in the department’s case management system using approved processes and procedures
- Keep up-to-date on patient care procedures which include diagnosis, pre-certification, prior authorization, pre-service and post-service denials
- Continuously stay up to date on various health issues and medical procedures necessary to offer top of the line feedback to members
- Mentor new team members
Requirements
What you’ll need- BSN or RN degree from an accredited college or university required
- Minimum three to five years clinical and/or medical management experience
- Active and unrestricted State or Multi-State RN License
- Understanding of medical terminology to assist in locating appropriate care options
- Strong Communication skills and phone etiquette
- Strong ability to explain complex issues to employees/retirees
- Highly effective listening skills
- Strong problem solving/issues resolution skills
- Excellent customer service and customer resolution skills
- Organizational and administrative skills
- Experience with Microsoft Word and Excel
- Ability to work in a team environment
Benefits
Comp & perks- Helping people every single day
- Training provided to do jobs well
- Supportive and friendly work environment
- Opportunities for growth and career advancement
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medical TerminologyCase ManagementPatient Care ProceduresDiagnosisPre-CertificationPrior AuthorizationHealth TestingTest Result InterpretationResearch ProvidersDocumentation
Soft Skills
Strong Problem Solving SkillsEffective Listening SkillsOrganizational SkillsTeam CollaborationPhone Etiquette
Certifications
RN License