Patient Navigator-2
Core
First-touch patient-facing role handling inbound/outbound tickets for non-CPL requests, care plan non-adherence, and voluntary PCP switches via a monitored call center.
Role type
Tier 1 Patient Navigator (Call Center)
Builds
Patient care navigation and administrative ticket resolution for a Medicare Advantage/managed care provider.
Domain
Healthcare / Medicare Advantage / Managed Care
Deliverable
client delivery
Required skills
Persuasion, active listening, de-escalation, meticulous documentation, verbal communication, CRM/case-management software proficiency, judgment for escalation
Preferred skills
Medicare Advantage concepts, bilingual proficiency (Spanish), prior experience in Medicare Advantage/managed care/medical office
Technologies
Microsoft Office, CRM, case-management software
Responsibilities
Engage patients to explain options and resolve tickets or escalate to Tier 2; document all cases for CMS audits; process PCP switch requests without retention pressure; recognize out-of-scope cases and route appropriately.
Seniority
Entry-level to Junior, hands-on IC