Field Patient Care Navigator & Advocate

aia; Bacolod; On-site; PHP 279,000 - 424,000; Full time

Job summary

MediCard Phils., Inc. is a leading HMO in the Philippines, founded and run by doctors, delivering service-oriented health care.

The company is seeking assertive, dynamic and energetic individuals to fill roles including Member Advocate and Healthcare Navigator to help members access the right care at the right time and cost. The positions focus on guiding members through care pathways, coordinating with providers, and ensuring medical necessity while maintaining a positive member experience and

Qualifications

• Member Advocate supports members in understanding and navigating healthcare benefits and services.
• Healthcare Navigator guides members through healthcare pathways and provider networks.
• Care Coordinator facilitates communication among members, healthcare providers, and MediCard.
• Utilization Steward ensures healthcare services are medically necessary, appropriate, and aligned with benefit entitlements.
• Brand Ambassador represents MediCard's commitment to service excellence and member-centered care.

Responsibilities

• Healthcare Navigation - Serve as the primary point of contact for members within assigned healthcare facilities.
• Benefit Implementation and Management - Verify member eligibility and benefit coverage; facilitate approvals and authorizations.
• Medical Appropriateness and Care Coordination - Coordinate with providers on covered services and ensure evidence-based practices.
• Member Experience Excellence - Deliver compassionate support; resolve concerns promptly; reflect brand promise.
• Provider Relationship Management - Develop positive relationships with hospital personnel and physicians.
• Operational and Compliance Excellence - Maintain accurate documentation and ensure SLAs.
• Brand Ambassador Responsibilities - Promote MediCard's brand promise and educate members about services.

Skills

Member Advocacy

Healthcare Navigator

Care Coordination

Utilization Steward

Brand Ambassador

Job description

MediCard Phils., Inc. is a leading HMO in the Philippines, founded and run by doctors, delivering service-oriented health care.

The company is seeking assertive, dynamic and energetic individuals to fill roles including Member Advocate and Healthcare Navigator to help members access the right care at the right time and cost. The positions focus on guiding members through care pathways, coordinating with providers, and ensuring medical necessity while maintaining a positive member experience and