Health Navigator- Customer Service Representative

Health Navigator Healthcare Services company looking for a Health Navigator to join their dynamic team. As a Health Navigator, you'll be the frontline of the Commercial Care Team, guiding members through their healthcare journey and making a positive impact on their lives. In this role your primary focus will be on: Site of Care Improvement: Ensuring members receive the right care at the right place. Readmission Prevention: Providing crucial pre and post-care support to keep members healthy and out of the hospital. Pediatric Wellness: Promoting wellness appointments to ensure our youngest members thrive. Job Responsibilities Conducting educational telephone calls advising members of available benefits, services, and programs; completing health needs assessments, and referring members to appropriate health management programs. Reaching out to members with identified gaps in care; encouraging compliance and assisting with locating providers and scheduling appointments. Managing system work queues; screening members for eligibility, prior case activities, claims, customer service inquiries, and authorization history; assigning members to clinical teams for call outreach and intervention. Facilitating research and analysis of inquiries/complaints related to processes, program designations, and other program-related matters. Working overtime as needed. Immunizations and medical tests may be required. Digital literacy assessment required. Job Qualifications Associates Degree in education, communication, health-related field, or equivalent work experience. 2 years in a customer service support role. Ability to work independently or in a team environment with shared responsibility. Proficient interpersonal and organizational skills. Strong decision-making and problem-solving abilities. Self-motivated with the ability to manage multiple tasks and prioritize effectively. Effective time management and communication skills. Knowledge of medical terminology. Proficiency in Spanish is not required but is strongly preferred.