Patient Continuity and Needs Advocate

Patient Advocacy & Connection

Evaluates patient needs and connects eligible individuals with health plans and community resources that suit their unique healthcare needs and enhances their care experience and outcomes.

Retention & Re-engagement

Proactively reaches out to disenrolled members to understand barriers to care and facilitates their return to our medical centers through personalized outreach and support.

Collaborative Partnership

Works closely with center leadership, sales teams, brokers and clinical staff to develop and execute targeted patient retention strategies that strengthen our patient-provider relationships.

Care Continuity

Safeguards seamless transitions and sustained engagement to prevent gaps in care that could lead to hospital visits or adverse health outcomes.

Documentation

• Utilizes an Electronic Medical Records (EMR) system, Medals and Salesforce to gather and store patient information, respond to questions on behalf of the patient and appropriately and timely document patient issues and resolutions.
• Maintains assigned work queue of patient accounts.
• Completes relevant patient documentation in compliance with all regulatory agencies, including HIPAA.

Knowledge, Skills And Abilities

• Competent level business acuity
• In-depth knowledge and understanding of general/core job-related functions, practices, processes, procedures, techniques and methods
• Fundamental knowledge and understanding of local, state and federal healthcare benefit services and plans
• Ability to build and maintain exceptional customer service relationships with healthcare services agencies, patients, providers and peers
• Dependable and time conscious
• Flexibility, agility, self-starter, comfortable with frequent changes and innovations
• Understanding of member attribution, eligibility and the disenrollment process
• Demonstrated skill in customer service and service recovery
• Knowledge of and experience in working with insurance brokers or agents preferred
• Detail-oriented with proficiency in Salesforce
• Strong written and verbal communication skills
• Positive attitude and the ability to build trust with internal and external partners
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
• Spoken and written fluency in English

Education And Experience Criteria

• High School diploma or GED equivalent required
• Bachelor's degree in a related field preferred OR additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis
• A minimum of three (3) years’ work experience required; working with seniors a plus as is a general understanding of Medicare Advantage