Care Guide

About the role

As a Care Guide at MVP Health Care, you will play a crucial role in enhancing our members' healthcare experience. This role supports a customer's care journey during their time with MVP through high quality interactions and experiences. The Care Guide works directly with customers and, as appropriate, customers' family and/or advocates to ensure that they have a smooth transition to their plan and fully understand their benefits and resources available to them as they use their plan. The Care Guide collaborates with Plan Guides during the sales processes to provide deep benefit and product knowledge that guides a prospective customer to their best plan options and serves as the escalation and transition point for customers with clinical needs to Care Management. This includes connection to resources that support, promote, and facilitate engagement in MVP programs that support the customer's health and wellbeing. The Care Guide will support the customer's care journey regardless of the intersection points with the plan, collaborating with a broader multi-disciplinary and/or other internal departments as appropriate to support the customer's ongoing needs in addition to onboarding. They will act as a liaison to support engagement with the plan, and coordination with Provider Partners in each of MVP's regions by assisting members in reducing/resolving challenges or barriers so that the member may achieve their optimal level of health, independence, safety, and well-being. The Care Guide identifies opportunities to develop relationships with customers that are meaningful to customers and expand their knowledge of MVP products and their support of member well-being. Ultimately, the Care Guide serves as the bridge between the customer, the health plan, and the customer's provider to create a seamless and positive experience to fulfill their unmet care needs. The Care Guide further coordinates and manages the resolution of highly complex and specialized, non-routine customer issues and supports Plan Guides and other Customer Care staff with expedited and non-routine customer issues. The Care Guide demonstrates MVP core values in all interactions with customers, customer advocates, and providers. The Care Guide will build individual capacity by increasing health and wellness self-management skills and sufficiency through a series of activities such as outreach, education, informal counseling, social supports, and advocacy. The position will empower customers to make informed decisions and advocate on their behalf when deemed necessary and be a resource for a future time in which the customer may have additional questions about their care, benefits, or coordination within the health system. Qualifications you'll bring: Associates degree in a health or human services field or equivalent Minimum of 3 years successful experience working within a managed care or health services environment. Experience in customer service and understanding and responding to customer needs. Experience in Managed Care and/or working relationships with Medicare, Medicaid, or Social Service Agencies a plus. Experience in positions where adherence to strict confidentiality and experience implementing process improvements is required Ability to empathize and 'be in the shoes' of MVP members, understand how issues impact them, and act as a member advocate. Willingness to meet directly with members, their families, advocates, in office, home settings or other as w