Personal Health Advocate

Location: Northern

## Personal Health Advocate Apply:
US Remote:
Full time:
Posted 3 Days Ago:
R13102

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company.  

Join our award winning team!
** 2025:**
* ** Stevie Awards for Sales & Customer Service:
** Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
** 2024:**
* ** Excellence in Customer Service Awards:
** Organization of the Year (Small)
* ** Stevie Awards for Sales & Customer Service:
** Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
* ** Best in Biz Awards:
** Most Customer-Friendly Company of the Year – Medium and large category (Silver)
As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For’ in the USA by Great Places to Work (GPTW)# ***
* * EVENING SHIFTS
* ****** Your Mission:
What Success Looks Like
** Your primary accountability and
** Personal Health Advocate, Registered Nurse
** is to deliver high-quality, member-centered clinical advocacy while meeting service, quality, and case management standards.

Success in this role includes consistently achieving:
** Member Advocacy & Clinical Guidance
*** Receive inbound member calls related to a wide range of healthcare issues (e.g., infertility, chronic disease, medications, diagnoses)
* Assess needs and determine the best course of action while adhering to established policies, procedures, and performance indicators (KPIs)
* Take ownership of member cases by going beyond the initial request and encouraging continued engagement
** Education, Trust & Relationship-Building
*** Educate members on their medical conditions, diagnostic testing, test results, and available treatment options
* Explain complex medical and benefit-related information clearly and compassionately
* Build trusted relationships that empower members to actively participate in their healthcare decisions
** Care Coordination & System Navigation
*** Provide members with options for healthcare providers and services based on clinical needs, geographic location, and benefit coverage
* Research providers through credentialing, education verification, and affiliations with recognized medical centers
* Facilitate communication between members, treating physicians, and insurance carriers
* Assist with scheduling and re-scheduling appointments, transferring medical records, resolving access issues, and clarifying benefit provisions
* Intercede on behalf of members to obtain earlier appointments or remove barriers to care
* Support members with prescriptions, pre-service fee negotiations, and authorization-related challenges
** Case Management, Documentation & Follow-Up
*** Maintain accurate, timely documentation using approved case management systems and procedures
* Place outbound follow-up calls when issues cannot be resolved during the initial interaction
* Respond to delegate box, answer service, and after-hours calls as required
* Escalate cases appropriately and on a timely basis to supervisors or internal clinical resources
** Professional Growth & Team Contribution
*** Stay current on patient care procedures, diagnoses, authorizations, denials, and evolving healthcare practices
* Mentor and support new team members as needed
* Collaborate with colleagues to maintain service excellence and balanced workflows
** Who You Are:
The Leader We’re Looking For
** You are an experienced nurse who…