Job Description
Job Description
As the Member Care Navigator, you will provide members with exceptional support by delivering high quality, professional, and efficient service. You will also liaise with members and providers to assist in the coordination of
care related to medical access complexities.
Answer incoming calls and support members in scheduling appointments and accessing appropriate care.
Maintain open, continuous communication between members and providers.
Research accepting physicians or facilities based on plan design, member needs, and access barriers.
Partner closely with Account Management, Contracting, Advocacy, Pre-Neg, and TPA teams to resolve access
issues.
Own the end-to-end member experience—from intake through resolution ensuring timely follow up,
documentation, and clear next steps.
Make outbound calls to providers, clients, and partners to gather information, educate stakeholders, and provide
updates.
Attend training and tea...
As the Member Care Navigator, you will provide members with exceptional support by delivering high quality, professional, and efficient service. You will also liaise with members and providers to assist in the coordination of
care related to medical access complexities.
Answer incoming calls and support members in scheduling appointments and accessing appropriate care.
Maintain open, continuous communication between members and providers.
Research accepting physicians or facilities based on plan design, member needs, and access barriers.
Partner closely with Account Management, Contracting, Advocacy, Pre-Neg, and TPA teams to resolve access
issues.
Own the end-to-end member experience—from intake through resolution ensuring timely follow up,
documentation, and clear next steps.
Make outbound calls to providers, clients, and partners to gather information, educate stakeholders, and provide
updates.
Attend training and tea...