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Family Health Advocate Jobs

Company

Sharecare

Address Atlanta, GA, United States
Employment type FULL_TIME
Salary
Category Wellness and Fitness Services
Expires 2023-06-04
Posted at 1 year ago
Job Description
:


Sharecare is the leading digital health company that helps people – no matter where they are in their health journey – unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com.


Job Summary:


The role of the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to members and their families through personalized resource and referral facilitation, issue resolution and healthcare navigation. Utilizing motivational interviewing and guided approaches, the family health advocate will play a critical role in supporting members to achieve their health goals, reduce costs and optimize quality care.


Essential Job Functions:


  • Claims adjustments
  • Member preferences management
  • Referring members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance
  • Preparing members for scheduled procedures/admissions
  • Grievances and appeals submissions
  • Is fully versed in and can explain plan benefit design, handles benefit and enrollment issues.
  • Drive member's engagement into appropriate programs and offerings.
  • Support for spending accounts, pharmacy, and disability.
  • Referring members to available 3rd parties for care management and second opinion.
  • Provide proactive care guidance for various value-add opportunities:
  • Utilization management intake or status
  • Interacts with members verbally and in written form to ensure appropriate engagement is achieved.
  • Community resource search
  • Aid with ordering durable medical equipment (DME)
  • Coordinate issue resolution with providers, payers or 3rd parties for:
  • Proactive benefits education for procedures
  • Answer inquiries from members (via voice and chat) for the following:
  • Help with eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and vision plans
  • Complex pharmacy inquiries
  • Provider search (PCP, specialty, and facility), focused on healthcare cost and quality, and present premier provider options, including but not limited to medical, dental, and vision plans
  • Be an educator on health care related inquiries.
  • Guidance on closing care gaps (e.g., No PCP, discussing switching from low quality PCPs to high quality PCPs, reminder for completion of health risk assessment, reminders for exams/tests due)
  • Primary duties include but are not limited to:
  • Complex spending account inquiries
  • Assistance with incentives and rewards
  • Understands and communicates the benefit design packages to members as defined by employer.


Specific Skills/ Attributes:


  • Excellent multi-channel communication and problem-solving skills
  • Ability to communicate effectively in both voice and chat channels, including critical thinking skills, effective typing, grammar, and spelling skills.


Qualifications:


  • Physical Therapy Assistant
  • Dental Assistant
  • Medical Coder
  • Pharmacy Technician
  • Experience in successful resolution of high level/sensitive customer service issues.
  • Medical Assistant
  • Nursing Assistant
  • Radiology Technician
  • High school / GED diploma
  • Occupational Therapist Aide
  • Health Guide/Advocate/Navigator
  • 2-yr associates degree in healthcare/health sciences OR equivalent experience in healthcare, preferably helping members navigate benefits and claims, OR held one or more of the following positions:
  • Patient Care Technician (PCT)
  • Phlebotomy Technician
  • Electrocardiograph (EKG) Technician
  • Medical Secretary/Clinic Manager
  • Home Health Aide
  • Experience in customer service in a healthcare contact center, provider office, or healthcare institution


Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.