Sharecare Hiring for Family Health Advocate – Remote at Texas, United States Full Time

Sharecare is the leading digital health company that helps people – no matter where they are in their health journey – unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com.

Job Summary:

The role of the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to members and their families through personalized resource and referral facilitation, issue resolution and healthcare navigation. Utilizing motivational interviewing and guided approaches, the family health advocate will play a critical role in supporting members to achieve their health goals, reduce costs and optimize quality care.

Essential Job Functions:

• Answer inquiries from members (via voice and chat) for the following:
• Help with eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and vision plans
• Provider search (PCP, specialty, and facility), focused on healthcare cost and quality, and present premier provider options, including but not limited to medical, dental, and vision plans
• Support for spending accounts, pharmacy, and disability.
• Assistance with incentives and rewards
• Aid with ordering durable medical equipment (DME)
• Community resource search
• Member preferences management
• Coordinate issue resolution with providers, payers or 3rd parties for:
• Claims adjustments
• Grievances and appeals submissions
• Utilization management intake or status
• Complex pharmacy inquiries
• Complex spending account inquiries
• Provide proactive care guidance for various value-add opportunities:
• Guidance on closing care gaps (e.g., No PCP, discussing switching from low quality PCPs to high quality PCPs, reminder for completion of health risk assessment, reminders for exams/tests due)
• Proactive benefits education for procedures
• Preparing members for scheduled procedures/admissions
• Referring members to available 3rd parties for care management and second opinion.
• Referring members to Clinical Advocates (Nurses) for conditions that require clinical care and case management assistance
• Primary duties include but are not limited to:
• Understand and communicate the benefit design packages to members as defined by the employer.
• Interacts with members verbally and in written form to ensure appropriate engagement is achieved.
• Is fully versed in and can explain plan benefit design, and handle benefit and enrollment issues.
• Drive members’ engagement into appropriate programs and offerings.
• Be an educator on healthcare-related inquiries.

Specific Skills/ Attributes:

• Excellent multi-channel communication and problem-solving skills
• Ability to communicate effectively in both voice and chat channels, including critical thinking skills, effective typing, grammar, and spelling skills.

Qualifications:

• High school / GED diploma
• 2-yr associate degree in healthcare/health sciences OR equivalent experience in healthcare, preferably helping members navigate benefits and claims, OR held one or more of the following positions:
• Patient Health Guide/Advocate/Navigator
• Patient Care Technician (PCT)
• Medical Secretary/Clinic Manager
• Medical Coder
• Claim Specialist
• Health Care Administration
• Benefit Specialist
• Experience in customer service in a healthcare contact center, provider office, or healthcare institution
• Experience in successful resolution of high-level sensitive customer service issues.

Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.