Healthcare Navigator & Member Advocate

AIA; Las Piñas; On-site; PHP 335,000 - 513,000; Full time

Job summary

MediCard Phils., Inc. invites applications for a Liaison Officer to serve as Care Partner and Member Advocate. You will guide members in accessing services, explain benefits, and coordinate with providers to ensure quality care within MediCard policies.

The role focuses on delivering an exceptional member experience, navigating complex healthcare situations, and promoting efficient utilization management across facilities nationwide.

Qualifications

• Bachelor/degree in a health-related field with current licensure preferred.
• Experience in HMO operations or managed healthcare is a plus.
• Strong knowledge of utilization management and case coordination.

Responsibilities

• Navigate member healthcare journeys within facilities; guide access to services and providers.
• Explain benefits, limitations, and coverage; support timely approvals and authorizations.
• Coordinate care with providers and ensure medically necessary, evidence-based practices.
• Deliver compassionate, professional member support and resolve concerns promptly.
• Develop positive relationships with hospitals and physicians to improve collaboration.
• Maintain compliant documentation and adhere to privacy and SLAs.
• Promote MediCard brand and educate members on services.

Skills

HMO Operations

Utilization Management

Case Management

Patient Relations

Healthcare Customer Service

Education

Nursing

Medical Technology

Physical Therapy

Pharmacy

Healthcare Administration

Allied Health Sciences

Other healthcare-related courses

Job description

MediCard Phils., Inc. invites applications for a Liaison Officer to serve as Care Partner and Member Advocate. You will guide members in accessing services, explain benefits, and coordinate with providers to ensure quality care within MediCard policies.

The role focuses on delivering an exceptional member experience, navigating complex healthcare situations, and promoting efficient utilization management across facilities nationwide.