Health Navigator - BlueCross BlueShield of Tennessee : Job Details

Are you passionate about making a difference in healthcare? We're looking for a Health Navigator to join our dynamic team. As a Health Navigator, you'll be the frontline of our 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.The hours for this position are: 9:00am-5:30 pm EST or 9:00am-6:00pm EST. You'll be asked to take the late shift one week each quarter (from 10:00am - 7:00pm EST).Proficiency in Spanish is not required, but is strongly preferred.Job ResponsibilitiesConducting 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 neededVarious immunizations and/or associated medical tests may be required for this position.This job requires digital literacy assessment. Job QualificationsEducationAssociates Degree in, education, communication, or health related field or equivalent work experienceExperience2 years - Experience in a customer service support role is requiredSkills/CertificationsAbility to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.Proficient interpersonal and organizational skillsIndependent, Sound decision-making and problem-solving skillsMust be able to work in an independent and creative manner.Self-motivated and able to manage multiple tasks and set priorities.Effective time management skillsExcellent oral and written communication skillsStrong interpersonal and organizational skillsKnowledge in Medical terminologyNumber of Openings Available:0Worker Type:EmployeeCompany:BCBST BlueCross BlueShield of Tennessee, Inc.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/NoticesBlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means. Tobacco-Free Hiring StatementTo further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results. Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.