Senior Care Advocate Representative

Overview

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.

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 surgeonsReceive inbound calls from members to educate them on their benefits and provide guidance with appointment schedulingAssist in the coordination of care across a variety of settings, while maintaining strict confidentiality and the highest level of professionalismUpdate all systems accordingly to document member engagementListen to member’s comments, concerns, and suggestions, relaying that information internally, while ensuring member satisfactionCollaborate with other departments and partnering companies as necessaryWork with health insurance counterparts to answer customer questions related to benefits, claims, and billingAnalyze a variety of problems and provide information/solutionsWork within a team to achieve performance targetsOther responsibilities as assigned

Qualifications

High school diploma with 3+ years of customer service experience; or Bachelor’s degree Customer-centric focus with excellent communications skillsExpress empathy with customers & compassion for their challengesPassion for healthcare improvementAbility to work independently and in small teamAgility- Ability to change direction quicklyTime management / task managementKnowledge of care coordination and case management concepts is preferred.Bilingual language skills preferred (English-Spanish or other)

USD $21.50/Hr. USD $21.50/Hr.