Care Navigator

Our company is a start-up that specializes in episodes of care benefit plans. We have a deep expertise in episode pricing and analytics and our goal is to bring transparency and efficiency to the healthcare market. Our company is committed to providing high-quality, affordable healthcare to our customers.

• Provide comprehensive support to members, helping them to understand and maximize their Episode Advantage benefits.
• Respond to inquiries via phone, email, or chat, offering clear and accurate information to resolve questions and concerns.
• Initiate outgoing communication to assist members in utilizing their benefits.
• Clearly explain details of Episode Advantage benefits, including covered services, benefit allowance, eligibility, co-payments, deductibles, and any limitations or exclusions.
• Guide members in using the member portal, focusing on functionalities related to Episode Advantage benefits to optimize their overall benefits usage.
• Handle and escalate member complaints, ensuring timely and satisfactory resolution.

• Assist and guide members to search for episodes of care and corresponding care groups and guaranteed pricing.
• Ensure members understand the value to them of selecting the appropriate site of care and care group for their need.
• Provide clinical guidance and information to members

• Knowledge of healthcare benefit plans and insurance terminology.
• Excellent communication and interpersonal skills.
• Empathetic, patient, and strong problem-solving abilities.
• Demonstrated ability to manage tasks in an orderly and efficient manner and maintain organized workflows.
• Experience in customer service, particularly in a healthcare setting, is preferred.
• Proficiency in navigating digital tools and member portals.
• Clinical knowledge including medical terminology and treatment plans preferred.
• Fluent in Spanish strongly preferred.