Remote Outreach Concierge Navigator (Bilingual in Spanish)
Core
Remote member support and outreach for seniors and chronically ill individuals to navigate healthcare access, benefits, and provider coordination.
Role type
Senior IC member services navigator (healthcare)
Builds
Coordinated care access and member engagement for Medicare Advantage/HMO plans
Domain
Healthcare / Medicare Advantage / Member Services
Deliverable
client delivery
Required skills
Medicare Advantage/HMO navigation, ICD-10 and CPT code knowledge, appointment scheduling, medical records retrieval, authorization and referral processing, eligibility verification, provider liaison, proactive outreach, case follow-up, quality assurance
Preferred skills
High-volume inbound customer service, escalation resolution, telemarketing, bilingual English/Spanish
Technologies
None explicitly stated
Responsibilities
Conduct in-market member engagement including welcome calls and onboarding; resolve member issues and coordinate care access; educate members on care gaps and schedule appointments; serve as patient liaison for program quality measures; place regular outreaches and communicate with PCPs; assist with authorizations, referrals, and medical records retrieval.
Seniority
Entry-level to Mid-level, hands-on IC