Member Care Navigator

AIA Hong Kong and Macau; Hinoba-an; On-site; PHP 300,000 - 480,000; Full time

Job summary

MediCard Phils., Inc. is seeking a proactive Liaison Officer to serve as a Care Partner and Member Advocate. The LO guides members through their healthcare journey, explains benefits, coordinates with providers, and promotes quality outcomes while ensuring policy compliance.

The role emphasizes member experience and efficient utilization management. Minimum qualifications include a healthcare degree and 2–3 years in HMO or hospital operations, with preference for licensed professionals.

Qualifications

• Bachelor's Degree in Nursing, Medical Technology, Physical Therapy, Pharmacy, Healthcare Administration, Allied Health Sciences or related field.
• RN or other licensed healthcare professional preferred.
• Minimum 2–3 years experience in HMO Operations, Hospital Operations, Utilization Management, Case Management, Patient Relations, Healthcare Customer Service.
• Experience in HMO or managed healthcare environment preferred.

Responsibilities

• Serve as the primary point of contact for members within assigned healthcare facilities.
• Guide members in accessing appropriate healthcare services and providers.
• Assist members in understanding healthcare benefits, limitations, and available options.
• Provide support throughout admission, confinement, treatment, and discharge processes.
• Facilitate referrals and coordination of care as needed.
• Assist members in navigating complex healthcare situations.
• Promote MediCard utilization and high-quality member experience.

Skills

Healthcare customer service

Case management

Utilization management

Hospital operations

HMO operations

Education

Nursing

Medical Technology

Physical Therapy

Pharmacy

Healthcare Administration

Allied Health Sciences

Other healthcare-related courses

Job description

MediCard Phils., Inc. is seeking a proactive Liaison Officer to serve as a Care Partner and Member Advocate. The LO guides members through their healthcare journey, explains benefits, coordinates with providers, and promotes quality outcomes while ensuring policy compliance.

The role emphasizes member experience and efficient utilization management. Minimum qualifications include a healthcare degree and 2–3 years in HMO or hospital operations, with preference for licensed professionals.