Job details
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Job type
- Full-time
Location
Plymouth Meeting, PA
Full job description
Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate’s supervisors are promoted from within the company. Join our award winning team!
2024:
- Excellence in Customer Service Awards: Organization of the Year (Small)
- Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For®’ in the USA by Great Places to Work (GPTW®)
Position Overview
Coordinate the activities and service of the team of Personal Health Advocates (RNs) Clinical Associates for specific shifts.
Perform administrative responsibilities and oversight to support services that assist members in navigating the healthcare system.
Ensure that Call Center Metrics are met or exceeded during the shift.
Work involves managing complex case files by utilizing employer/carrier information, health resources (as directed by Health Advocate™), medical directors, and subject matter experts within Health Advocate™.
Latitude for independent action and sound judgment with the oversight of the Call Center Supervisors and Managers.
Regular contact with employees, members, physician offices, hospital staff, nursing networks, insurance carriers, community organizations, and federal, state, and county employees.
Essential Job Functions
- Ensure that the Call Center Metrics are met or exceeded
- Coordinate the clinical team for that shift
- Provide organization and direction for intake calls and phone queue assignments to ensure all calls are answered in accordance with Health Advocate’s policies and procedures
- Provide leadership and promote effective teamwork during designated shift
- Provide oversight and direction to staff for assigned cases during shift
- Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts
- Take responsibility for a complex case management portfolio
- Take queue calls and manage case
- Provide clinical consultation and support when appropriate to all internal departments
- Routinely evaluate and monitor call center needs procedures to recommend any necessary changes to the Director of Clinical Operations
- Escalate cases through the appropriate channels in accordance with Health Advocates policies and procedures
- Communicate and Collaborate with Clinical and Operational Supervisors.
Requirements
- Prior relevant call center experience
- Active and unrestricted State or Multi-State RN license
- Minimum five years clinical and/or medical management experience
- Strong leadership skills and the ability to build effective teams
- Telephone triage experience helpful
- Case Management experience helpful
- Understanding of health benefit plans and the insurance industry
- Understanding of physician office procedures, including billing, diagnosis codes, and pre-certification process
- Understanding of Home Care Services
- Strong desire to provide outstanding customer service
- Ability to work as part of a team
- Ability to educate callers
- Strong listening skills and empathy
- Ability to ask open-ended questions and uncover information
- Effective communication skills to interact with members, physicians, and insurance carrier representatives
- Special ability in mediating or negotiating compromises without alienating any party
- Ability to calm anxious callers and defusing angry or hostile callers
- Assertive, self-confident, and resilient
- Attention to detail and strong documentation skills
- Proficient computer skills (Microsoft Office, Excel, Outlook, Adobe PDF, Internet Searches)
Mental and Physical Requirements
- This position is a remote position. The employee will need to have a dedicated HIPPAA compliant workspace. Have access to internet and router.
- The nature of the work in this position is sedentary and the incumbent will be sitting most of the time
- Essential physical functions of the job include grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the workday
- Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work
Related Duties as Assigned
- The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents
- Consequently, job incumbents may be asked to perform other duties as required
- Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above
- Please contact Leaves@healthadvocate.com to request a review of any such accommodations
Company Overview
Health Advocate is the nation’s leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need.
Learn more
Health Advocate
Awards:
2023:
- National Customer Service Association All-Stars Award: Service Organization of the Year.
- Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
2022:
- Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
- Excellence in Customer Service Awards: Organization of the Year (Small)
- Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)
2021:
- Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Silver Winner
- Stevie® Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner
- Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)
2020:
- National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up
- Communicator Award of Distinction: October 2019 Broker News
- MarCom Awards: Gold, COVID Staycation Ideas brochure
- MarCom Awards: Platinum, 2021 Well-being Calendar
- Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium category (Silver)
Health Advocate is an Equal Opportunity Employer that does not discriminate on the basis of race, color, sex, age, religion, national origin, citizenship status, military service and veteran status, physical or mental disability, or any other factor not related to job requirements. We respect and value diversity, and are committed to the principles of Equal Employment Opportunity.
VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans.
PAY TRANSPARENCY NONDISCRIMINATION PROVISION
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-I.35(c)
