Aston Carter Family Health Advocate - Remote in Seattle, Washington
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:
o Answer inquiries from members (via voice and chat) for the following:
o Help with eligibility, benefits education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, and utilization management (UM) status, including but not limited to medical, dental, and vision plans
o 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
o Support for spending accounts, pharmacy, and disability.
o Assistance with incentives and rewards
o Aid with ordering durable medical equipment (DME)
o Community resource search
o Member preferences management
o Coordinate issue resolution with providers, payers, or 3rd parties for:
o Claims adjustments
o Grievances and appeals submissions
o Utilization management intake or status
o Complex pharmacy inquiries
o Complex spending account inquiries
o Provide proactive care guidance for various value-add opportunities:
o Guidance on closing care gaps (e.g., No PCP, discussing switching from low-quality PCPs to high-quality PCPs, a reminder for completion of health risk assessment, reminders for exams/tests due)
o Proactive benefits education for procedures
o Preparing members for scheduled procedures/admissions
o Referring members to available 3rd parties for care management and second opinion.
o Referring members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance
M-F, 8-hour shift assigned between 8 am - 8 pm EST
Training: 9:30am-6pm EST
About Aston Carter:
Please Note: Scammers are posing as Aston Carter. We'll never contact you via Gmail, Telegram, or WhatsApp and we'll never solicit money from you.
At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.
Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email firstname.lastname@example.org (%email@example.com) for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
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