Allied Care Navigator

POSITION SUMMARY

The Allied Care Navigator is responsible for providing concierge-level support to members through their care journey, assisting with finding a curated list of high-quality, low-cost specialists in their network. They have a comprehensive understanding of member’s medical plan, employer point solutions available, assist with scheduling appointments, and providing ongoing assistance. They utilize their past industry experience and critical thinking in a collaborative process to review and facilitate appropriate health services and benefits for members. 

ESSENTIAL FUNCTIONS

• An extensive understanding of medical plan documents, member advocacy, and cost containment programs, and employer point solutions available to assist members with understanding their covered benefits and financial responsibility for services. 

• Maintain a professional and empathetic demeanor while being responsive to member inquiries to prevent delays in care. 

• Ability to communicate effectively both verbally and in writing to all parties involved in the member’s referral process; ensuring coordination of care is conducted and ongoing support is provided through the confirmation of services being performed.  

• Utilize best in class web-based tools to research high-quality and cost-effective providers in the member's network, maximizing their benefits and providing a curated list.  

• Independently manage daily tasks within internal systems within assigned turnaround times. Tasks include, but are not limited to, responses to inquiries made by members and providers and confirmation of appointment attendance and scheduling.  

• Document potential impact and savings following appointment confirmation to ensure accurate reporting of the value of the service provided. 

• Collaborate with internal and external partners to coordinate member care, document updates in appropriate systems, and update ongoing impacts.   

• Develop and maintain written operational procedures for all tasks performed and cross train to provide effective support to all team members. 

• Strategize with Medical Management Leadership to discuss trends identified related to member cases.

• Performs other related duties as assigned.

EDUCATION

• Bachelor's degree or equivalent work experience required.

EXPERIENCE AND SKILLS

• 2+ years of experience member advocacy or care coordination.
• Working knowledge of employee medical benefit plans.
• Experience with Group health insurance and self-funded health plans preferred.
• Highly skilled in written and verbal communication. 
• Intermediate level work experience with Microsoft Office suite of products. 

• POSITION COMPETENCIES: Communication
• Customer Focus
• Accountability
• Functional/Technical Job Skills

PHYSICAL DEMANDS

• This is a standard desk role – long periods of sitting and working on a computer are required.

WORK ENVIRONMENT

• Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.