Address
Form of work
SalaryOverview:
** The work schedule will be Monday - Friday from 11:30am - 8pm EST **
Responsibilities
Specialist Management Solutions (SMS) is an early stage start up backed by SCA Health, a division of United Health Group. The mission of SMS is to empower consumers with the knowledge and education to understand their healthcare costs, coupled with seamless access and enhanced consumer experience when they need those services. SMS was founded by SCA leaders after recognizing a substantial need to better reach and influence consumers to take ownership of their healthcare costs. Healthcare benefits are complex, and many consumers find themselves frustrated with the lack of transparency in the system, simple means of understanding costs, and how to access the care they need. The SMS model is intentionally designed to provide a simple solution to large, self-insured employers to drive down outpatient surgical spend. The model is built around the ability to engage and educate membership to create an exceptional member experience. The SMS goal is to empower members to be well-informed to be true consumers of healthcare. SMS streamlines services and impacts pull through by redirecting patients to affordable, quality settings for surgical care.
Accountabilities / Responsibilities:As a Senior Care Advocate you will be the face of Specialist Management Solutions (SMS) to our customers. This is a Medical Concierge (White Glove) service where you’ll deliver a personized, empathetic consumer experience as they navigate the complexity of the healthcare system. This will include answering questions and resolving issues in collaboration with teams across the company, healthcare providers, and insurance companies. You will be primarily engaging with our customers telephonically, but you will develop strong relationships with them as they complete their healthcare journey.
** The work schedule will be Monday - Friday from 11:30am - 8pm EST **
Responsibilities
- Predominate amount of work surrounding calling members to inform them of their benefits and act as a care guide on behalf of the customer helping them receive treatment from a network of high-quality surgeons
- Receive inbound calls from members to educate them on their benefits and provide guidance with appointment scheduling
- Assist in the coordination of care across a variety of settings, while maintaining strict confidentiality and the highest level of professionalism
- Update all systems accordingly to document member engagement
- Listen to member’s comments, concerns, and suggestions, relaying that information internally, while ensuring member satisfaction
- Collaborate with other departments and partnering companies as necessary
- Work with health insurance counterparts to answer customer questions related to benefits, claims, and billing
- Analyze a variety of problems and provide information/solutions
- Work within a team to achieve performance targets
- Other responsibilities as assigned
- High school diploma with 3+ years of customer service experience; or Bachelor’s degree
- Customer-centric focus with excellent communications skills
- Express empathy with customers & compassion for their challenges
- Passion for healthcare improvement
- Ability to work independently and in small team
- Agility- Ability to change direction quickly
- Time management / task management
- Knowledge of care coordination and case management concepts is preferred.
- Bilingual language skills preferred (English-Spanish or other)
