2 years - Experience in a customer service support role is required
Skills\Certifications
Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
Proficient interpersonal and organizational skills
Independent, Sound decision-making and problem-solving skills
Must be able to work in an independent and creative manner.
Self-motivated and able to manage multiple tasks and set priorities.
Effective time management skills
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Knowledge in Medical terminology
Number of Openings Available
1
Worker Type:
Employee
Company:
VSHP Volunteer State Health Plan, Inc
Applying for this job indicates your acknowledgement and understanding of the following statements:
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
Benefits
Health insuranceVision insuranceRemote work options
Additional Information
We are hiring a Health Navigator at BCBST!
In this role, you will support BlueCare Plus Clinical Support at BCBST by serving as a key point of contact for members navigating their healthcare needs. You will assist members by answering questions, completing Health Risk Assessments, and ensuring timely, accurate support through both phone interactions and administrative coordination.
This position combines inbound and outbound phone support with clerical responsibilities, allowing you to engage directly with members while also supporting operational workflows that contribute to effective care delivery. You will work closely with members to understand their needs, provide guidance, and help them access appropriate services and resources.
You will play an important role in improving the overall member experience by delivering compassionate, member-centered support, responding to inquiries with empathy, and helping ensure smooth coordination of care. Responsibilities also include documenting interactions, supporting team processes, and contributing to improved member engagement and satisfaction.
The ideal candidate has experience in a medical office setting or working with senior populations. Success in this role requires strong communication skills, patience, attention to detail, and the ability to work independently. Familiarity with medical terminology is preferred.
We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work - guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.
Note:
This is a remote role within a collaborative and supportive team environment
Schedule: Weekly Rotating shifts of 7:30-4:00 p.m., 8:00-4:30 p.m., 8:30-5:00 p.m. and 9:00-5:30 p.m. EST
Overtime may be required based on business needs
Job Responsibilities
Conducting educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries.
Work overtime as needed
Various immunizations and/or associated medical tests may be required for this position.
This job requires digital literacy assessment.
Job Qualifications
Education
Associates Degree in, education, communication, or health related field or equivalent work experience
Bcbst · TN, Chattanooga, Remote