Health Navigator-Q

We are hiring a Health Navigator at BCBST!

In this role, you will support the BlueCare Plus team by helping members schedule wellness visits, coordinate follow-up care, and address their needs at home. You’ll act as a trusted guide, helping members understand their benefits, close gaps in care, and access the resources they need to live healthier lives.

You will serve as a key point of contact for members, motivating them to take important steps toward better health by helping overcome barriers such as scheduling appointments, finding providers, and connecting to the right programs. Every interaction you have will contribute to improved health outcomes and a better member experience.

To be successful in this role, you’ll bring strong communication skills, patience, and the ability to work independently. You will be a strong candidate if you have experience in customer service, a medical office setting, or working with senior populations, along with knowledge of medical terminology. Experience in healthcare, care coordination, member engagement, or population health will further strengthen your candidacy.

We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work — guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.

• →Conducting educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
• →Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
• →Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
• →Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries.
• →Work overtime as needed
• →Various immunizations and/or associated medical tests may be required for this position.
• →This job requires digital literacy assessment. 

Education

• Associates Degree in, education, communication, or health related field or equivalent work experience

Experience

• 2 years - Experience in a customer service support role is required

Skills\Certifications

• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Proficient interpersonal and organizational skills
• Independent, Sound decision-making and problem-solving skills
• Must be able to work in an independent and creative manner.
• Self-motivated and able to manage multiple tasks and set priorities.
• Effective time management skills
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Knowledge in Medical terminology

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices