Care Guide

About the role

At MVP Health Care, you’ll play a crucial role in enhancing our members' healthcare experience. This role supports a customer’s care journey during their time with MVP through high-quality interactions and experiences.

Responsibilities

• Play a crucial role in enhancing our members' healthcare experience.
• Support a customer's care journey during their time with MVP through high quality interactions and experiences.
• Work directly with customers and, as appropriate, customers' family and/or advocates to ensure they have a smooth transition to their plan and fully understand their benefits and resources available to them as they use their plan.
• Collaborate with Plan Guides during the sales processes to provide deep benefit and product knowledge that guides a prospective customer to their best plan options and serves as the escalation and transition point for customers with clinical needs to Care Management.
• Support the customer's care journey regardless of the intersection points with the plan, collaborating with a broader multi-disciplinary and/or other internal departments as appropriate to support the customer's ongoing needs in addition to onboarding.
• Act as a liaison to support engagement with the plan, and coordination with Provider Partners in each of MVP's regions by assisting members in reducing/resolving challenges or barriers so that the member may achieve their optimal level of health, independence, safety, and well-being.
• Identify opportunities to develop relationships with customers that are meaningful to customers and expand their knowledge of MVP products and their support of member well-being.
• Serve as the bridge between the customer, the health plan, and the customer's provider to create a seamless and positive experience to fulfill their unmet care needs.
• Further coordinate and manage the resolution of highly complex and specialized, non-routine customer issues and support Plan Guides and other Customer Care staff with expedited and non-routine customer issues.
• Demonstrate MVP core values in all interactions with customers, customer advocates, and providers.
• Build individual capacity by increasing health and wellness self-management skills and sufficiency through a series of activities such as outreach, education, informal counseling, social supports, and advocacy.
• Empower customers to make informed decisions and advocate on their behalf when deemed necessary and be a resource for a future time in which the customer may have additional questions about their care, benefits, or coordination within the health system.

Qualifications

• Associates degree in a health or human services field or equivalent.
• Minimum of 3 years successful experience working within a managed care or health services environment.
• Experience in customer service and understanding and responding to customer needs.
• Experience in Managed Care and/or working relationships with Medicare, Medicaid, or Social Service Agencies a plus.
• Ability to empathize and 'be in the shoes' of MVP members, understand how issues impact them, and act as a member advocate.
• Willingness to meet directly with members, their families, advocates, in office, home settings or other as warranted by customers.
• Commitment to high ethical standards in all work.
• Protects the privacy of member and MVP data and exercises discretion in handling confidential member information.
• Deep knowledge of Medicare, Medicaid, Commercial programs and products and understanding of current health care market and products/resources available in the community, social services, and public resources.
• Ability to collaboratively work with team to assist and resolve customer concerns and complaints.
• Strong communication and interpersonal skills, both verbal and written.
• Excellent ability to communicate independently and directly with customers, providers and staff with calmness, assertiveness, diplomacy and in a non-confrontational manner with the goal being to engage successfully with customers.
• Ability to incorporate Evidence Based Innovation (EBI) practices and information into day-to-day customer engagement.
• Demonstrated organizational skills, accountability, and personal ownership of work.
• Excellent problem-solving and analytical skills.
• Ability to identify trends in information, appropriately interpret information, and draw good conclusions from incomplete information.

Skills

• Customer service skills.
• Collaborative teamwork.
• Problem-solving.
• Communication.
• Healthcare knowledge.
• EBI practices.

Benefits

• Competitive compensation and comprehensive benefits focused on well-being.
• Opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace.

Pay

MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role. We do not request current or historical salary information from candidates.

Schedule

Hybrid Schedule