Care Guide

About the role

Join Us in Shaping the Future of Health Care At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.

Responsibilities

• Complete new customer welcome calls and support their transition to the Plan.
• Provide ongoing information and assistance to customers to support accessing MVP programs, including connection with clinical programs and care management resources.
• Build enduring relationships with customers.
• Orient new members to specific product offerings and the services of the role.
• Ensure the customer has a significant degree of understanding of their benefits, eligibility for certain services, and talk through and coordinate transition of care items.
• Aid customers in addressing unmet needs recognizing that customers have needs beyond their standard benefit coverages.
• Facilitate reduction of care disruption or delays in care and connection to clinical programs and Care Management resources.
• Facilitate access to services which are culturally appropriate, meet the customer's stated need for service and enhance the quality-of-service delivery.
• Promote knowledge of health delivery system(s) to empower customer.
• Collaborate with MVP Quality Management to support performance measurements.
• Address other service needs as they arise from customers.
• Accountable for resolution of highly complex customer issues.
• Facilitate resolution of real and perceived disruptions of care as customer enrolls in MVP Medicare Advantage Product.
• Participation in cross-departmental and external meetings and activities supporting customer, including with Care Pods and provider partners.
• In-person attendance with Plan Guides at MVP events to support prospective customer inquiries.
• On-site interactions with customers at MVP offices, community events, provider offices, etc.

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
• Healthcare knowledge
• Communication skills
• Problem-solving skills
• Organizational skills
• Evidence-Based Innovation (EBI) practices

Benefits

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.

Pay

$51,395.00-$68,354.75

Schedule

Hybrid

Company Information

MVP Health Care is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.