Healthcare Benefits Navigator

The Role

The Benefits Navigator is instrumental in supporting customers with Medicare drug plan selection, plan optimization and plan enrollment. Responsible for providing Medicare drug plan comparisons and educating our customers on available plan options in the market. Through conducting plan comparisons, the Benefits Navigator ensures customers understand out of pocket expenses under available plans.

The second important function of this role is speaking with Non-dispense Residents (NDRs) that admit into the facilities we service and attempt to win over their business. This role reports to the Director, Plan Optimization and Services and works with other Benefit Navigators to maximize customer savings and provide a seamless enrollment process.

Day-to-Day Responsibilities

• Utilize reporting to identify newly admitted potential customers and/or current customers that may qualify for a Special Enrollment Period.
• Using pharmacy’s point of sale system in conjunction with an online vendor, explain customer’s current insurance coverage and provide personalized plan comparison ensuring customer understands available plan options and can make informed plan selection.
• Receive inbound and place outbound calls to facilities and customers to provide plan comparison and plan optimization.
• Aid customers in plan enrollment.
• Use scheduling software to schedule appointments with customers for plan optimization during Medicare Open Enrollment facilitating seamless and efficient enrollment process.
• Facilitate warm transfer to customers requesting a licensed insurance agent.
• Accurately track customer assistance and record enrollment progress.
• Provide customer service to internal and external customers as needed.
• Through customer engagement and satisfaction, assist in the achievement of National Account partnered objectives.
• Make quality cold calls to potential customers explaining LTC pharmacy services provided and how it assists the facility in proper medication management.

Education

• High School diploma required
• College degree in business preferred
• Pharmacy Technician registration preferred

Knowledge, Skills, And Abilities

• Pharmacy experience preferred
• Strong knowledge of 3rd party insurance requirements
• Collections and claim adjudication experience preferred
• FrameworkLTC or QS1 experience preferred
• Excellent computer skills, including MS Office (Excel, Word, Teams)
• Excellent verbal and written communication skills; professional demeanor
• Strong attention to detail and analysis skills
• Ability to maintain confidentiality at all levels
• Ability to work to deadlines and balance multiple priorities
• Strong work ethic and desire to excel
• Bilingual (English/Spanish) desired but not required

Required Attributes

• Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
• Strategy and Planning – ability to think ahead, plan and manage time efficiently
• Problem Solving – ability to analyze causes and solve problems at both a strategic and functional level with minimal direction
• Team Oriented – ability to work effectively and collaboratively with all team members
• Detail Oriented – ability to provide attention to detail
• Organizational – ability to organize work around multiple priorities and deadlines

What We Offer

• Compensation & Financial – Competitive pay
• 401(k) with company match
• Family, Health & Insurance Benefits (Full-Time employees working 30+ hours/week only)
• Medical, Dental and Vision
• Health Savings Accounts and Flexible Spending Accounts
• Company-paid Basic Life and Accidental Death & Dismemberment
• Company-paid Long-Term Disability and optional Short-Term Disability
• Dependent Care Flexible Spending Accounts
• Wellbeing Employee Assistance Program (EAP)
• Guardian Angels (Employee assistance fund)
• Time Off – Paid holidays and sick days
• Generous vacation benefits based on years of service