Remote Patient Advocate Jobs

Must have knowledge of basic spreadsheet, word processing, and data entry skills.

Must have strong organizational skills and be able to effectively manage and prioritize tasks.

High School Diploma or the equivalent plus a minimum of one year medical terminology or medical services experience required.

Must be proficient and comfortable in a computer based environment. Experience in a call center environment preferred.

Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.

Advancement opportunities, professional skills training, and tuition Reimbursement

Proactively reach out to individuals via phone to offer help and support according to program requirements.

A time management guru: you efficiently move through a to-­do list and effectively prioritize and triage competing demands

You have excellent interpersonal skills (communication and listening), especially over the phone, and a willingness to receive feedback

You are interested in working remotely and reside in Florida, Texas, North Carolina, Georgia, Arkansas, Wisconsin, or Minnesota

Growth-oriented: you thrive on constructive feedback, which you view as an opportunity to polish skills

Must have a wired internet connection and appropriate network quality and internet speed to perform the job remotely.

Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient certification and/or prior authorization requests.

Initiates and manages clinical referrals for members.

What are your key responsibilities?

Acts as a liaison between hospitals, physicians, health plans, vendors, patients, or referral sources.

Verifies and obtains authorizations if needed. Enters referrals and documents communications, actions, and other data in departmental systems.

Refers cases requiring clinical review to appropriate clinical professionals.

·Responds to, research and/or assists with priority inquiries and special projects as required by management.

·Maintains accurate records on complaints and/or other customer comments and makes recommendations for changes to management.

·3 years-experience in call center, insurance, or related field

·Provides prompt, accurate, thorough, and courteous responses to all customer inquiries.

·Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures.

·Performs research as needed to resolve inquiries.

Experience with Vendor Management Systems, Digital Marketing, E-Commerce, and Merchandising

15% - Tracks content performance, digital asset management, assortment opportunities via regular reporting.

Major Tasks, Responsibilities And Key Accountabilities

10% - Offers industry expertise and acts as the subject matter expert for the supported assortment/category.

5% - Builds system knowledge and expertise through ongoing tailored, training classes.

Experience with SQL, Tableau and Adobe products

Experience with Vendor Management Systems, Digital Marketing, E-Commerce, and Merchandising.

10% System Knowledge - Builds system knowledge and expertise through ongoing tailored, training classes.

This Position typically reports to Manager, Brand Advocate

Experience with SQL, Tableau and Adobe products.

Manages multiple projects with competing priorities.

Strong written and oral communication skills.

Experience working in healthcare setting, Medical or Healthcare Social Work in similar setting, or Case Management role

Knowledge of the concepts and principles of case management

Knowledge of HIPPA confidentiality requirements

Knowledge of third-party payer requirements

Be knowledgeable about and provide information to patients regarding available community services that could enhance their care.

Coordinate patient care and treatment plans; provide educational materials/consultation; follow up on patient well-being.

Excellent interpersonal skills and communication skills

Works with the Compliance Department to lead staff trainings.

2+ years minimum in a mental healthcare setting

Strong service orientation and sensitivity to patient’s needs

Ability to deal with a variety of healthcare organization/delivery, satisfaction measurement, personalities w/tact & diplomacy

What’s In It For You

At least one year of work experience as a patient advocate, case manager, health navigator, or equivalent is required

Ensure that Patient Advocates are completing all responsibilities related to programs, policies, and procedures related to the advocate role

Work with Advocacy Program Manager to address employee performance issues, and develop corrective action plans, as needed

Assist the Advocacy Program Manager with presentations, orientations, in-services, and trainings for program staff

Seek out additional tasks and opportunities from Advocacy Manager and/or Programs Director, when time permitted

Perform related duties and fulfills responsibilities, as required

Insurance benefit knowledge in healthcare preferred

2-3 years of experience in a healthcare/clinical setting

Excellent written and verbal communication skills

Strong organization and planning skills; detail oriented

Conflict resolution and problem-solving skills

Reviews the accuracy of demographics, insurance, completion of forms, organizational data to be entered in the chart in a timely manner.

We offer competitive compensation and benefits such as holiday pay, PTO, medical, dental, vision and Work-Life balance, to name a few.

Demonstrates superior product knowledge; accurately describes the features & benefits of all products using the appropriate tools.

Responsible for coordinating delivery date and time, set expectations for pick up, seeks feedback about experience and asks for referrals.

Establishes a compassionate environment through interactions with patients and caregivers.

Documents patient interactions in the electronic medical record (EMR) and other software platforms.

Monitors clinical status of patients (e.g., medication adherence and referral follow-ups) through dedicated EMR and software.

Become proficient in learning the Aerial program to review information re: Case Management

Attends weekly Health Partners meeting with Benefit Team at Whirlpool, Account Managers and Health Coaches

Demonstrated team leadership experience and/or skills

Clinical experience and/ or a Managed Care background

Knowledge of medical claims administration and employee benefit plans

Attend meetings with account manager, client, vendors, and other healthcare team members as needed

Requires ability to work independently identifying best approaches to problems/questions and determine when to seek management advice

Advanced critical thinking and problem solving skills required

Requires at least four (4) years of related work experience

Requires strong written and communication skills. Ability to speak effectively in high level forums and field questions and inquiries with confidence

Requires computer competence, including familiarity with Word and Excel as well as experience working with databases

Experience with operational development and execution preferred

THE MINIMUM QUALIFICATION REQUIREMENTS ARE

Drug Screen Authorization Form (PDF)

Request for Administrative Review (PDF)

MUST BE AVAILABLE TO WORK SHIFTS AS NECESSARY BASED ON HOSPITAL OPERATIONS; SERVICES ARE PROVIDED 24/7.

All West Hawaii Health Care Facilities are Nicotine Free

ALL JOB VACANCIES WILL BE POSTED FOR A MINIMUM OF TEN (10) CALENDAR DAYS

Experience working with and documenting via CRM or other tracking method. Effective verbal and written communication skills.

Manage internal processes that may be manual in nature while thinking strategically toward a smarter method…incorporating opportunities for efficiency/automation whenever possible.

Associate degree, or high school diploma with 5-7 years related experience. Bachelor’s degree preferred.

Effective interpersonal skills with a service minded team attitude.

Maintain partner profiles, contact lists, distribution addresses and other methods of contact which affect client connections.

Be flexible to adjust duties as needed to coordinate with business needs and industry trends.

Initiates referrals to managed care for Health maintenance organization (HMO) authorizations.

Provides financial counseling for patients before starting/during treatment regarding insurance benefits and out-of-pocket expenses.

Equivalent experience will be accepted in lieu of the required degree or diploma.

Verifies all insurance and eligibility information is accurate and updates insurance records if necessary.

Responsible for obtaining initial and subsequent Preferred provider organization (PPO) authorizations.

Follows-up to ensure medications are delivered to patients in a timely manner.

8. Develops and manages policies and procedures for complaint/grievance management.

1. Identifies, manages, resolves, and tracks patient/family complaints/concerns/grievances.

3. Manages the incident reporting system for patient complaints, managing the data for tracking/trending of complaints/grievances.

5. Investigates the substance of the complaint including along with the department manager and other relevant individuals.

7. Follows departmental practices to meet regulatory requirements for response to patient/family with resolution of the investigation.

Minimum of an Associate’s degree in Nursing Required, Bachelor’s preferred.

Minimum of one (1) year experience in food service management preferred in an acute care setting

Certified Dietary Manager certificate, Registered Diet Technician or Registered Dietitian, preferred

Possess the necessary skills to effectively utilize Microsoft office applications, electronic medical record, and diet office systems

Establishes goals and oversees implementation of patient food services needs based upon medical direction and patient population

Hires, directs, coaches, trains, and develops patient service team members

Ensures patient services staff assists in achieving stated patient satisfaction goals

Strong organizational skills and able to effectively manage and prioritize tasks.

Minimum of one year medical terminology, healthcare or medical services experience required.

Experience in a call center environment preferred.

Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.

Advancement opportunities, professional skills training, and tuition Reimbursement

Responsible for servicing patients making incoming calls with questions and/or returning messages for their Nurse Coach.

Strong organizational skills and able to effectively manage and prioritize tasks.

Minimum of one year medical terminology, healthcare or medical services experience required.

Experience in a call center environment preferred.

Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.

Advancement opportunities, professional skills training, and tuition Reimbursement

Responsible for servicing patients making incoming calls with questions and/or returning messages for their Nurse Coach.