Member Navigator

Job Description

Job Description

Description :

Mass Advantage is a Medicare Advantage company, located in Worcester, MA. We are affiliated with the largest health care system in Central Massachusetts, UMass Memorial Health. They are the clinical partner of the University of Massachusetts Chan Medical School, with access to the latest technology, research and clinical trials.

We are currently seeking Member Navigator; this position is a hybrid position (remote / office). Our Member Navigators are the face of the health plan and are key to success in making our members feel like part of an organization that is here for them. Navigators are the main point of support for our members. You will be responsible for providing support in a caring and personal manner that you would want for your own family member. Mass Advantage will teach, encourage, and empower you to be a subject matter expert in Plan Benefits and the Network’s resources to provide the best service possible. You will be part of a team of resources from both the Plan and Health System so that you can seamlessly help members with transition of care and services and clinical questions. Mass Advantage will provide initial and on-going member services training.

As a Member Navigator you will be in a unique position to learn what is important to our members and where our members have difficulty navigating the healthcare system. You will be responsible for documenting and bringing this critical information back to the care team. This role was established with the goal of providing a key contact person with whom the member can feel comfortable reaching out for assistance and with questions or concerns at any time.

Requirements :

• High School diploma or GED required
• 3 plus years call center experience.
• 3 plus years of experience in a customer-serving atmosphere.
• 2 plus years of experience with an insurance / payor preferred.
• Basic understanding of insurance and medical terminology.
• Medicare knowledge strongly preferred.