Member Care Navigator & Advocate

AIA Hong Kong and Macau; Pasig; On-site; PHP 450,000 - 650,000; Full time

Job summary

MediCard Phils., Inc. is seeking a Liaison Officer to serve as a Care Partner and Member Advocate within healthcare facilities. You will guide members through their healthcare journey, coordinate with providers, and promote quality outcomes while ensuring policy compliance and utilization guidelines.

The LO role emphasizes exceptional member experience, timely benefit utilization, and collaboration with hospital staff to optimize care pathways across admission, treatment, and discharge stages.

Qualifications

• Bachelor's degree in a healthcare-related field.
• Experience in HMO operations or hospital operations is preferred.
• Familiarity with utilization management and case management is beneficial.

Responsibilities

• Healthcare Navigation: be the primary contact for members within facilities and guide them to needed services.
• Benefit Implementation and Management: verify eligibility, process approvals, and explain coverages and exclusions.
• Medical Appropriateness and Care Coordination: coordinate with providers and support evidence-based practices.
• Member Experience Excellence: deliver compassionate support and resolve concerns promptly.
• Provider Relationship Management: foster positive relationships with hospital staff and physicians.
• Operational and Compliance Excellence: maintain records and ensure SLAs and privacy compliance.
• Brand Ambassador Responsibilities: promote MediCard’s services and educate members about offerings.

Education

Nursing

Medical Technology

Physical Therapy

Pharmacy

Healthcare Administration

Allied Health Sciences

Other healthcare-related courses

Job description

MediCard Phils., Inc. is seeking a Liaison Officer to serve as a Care Partner and Member Advocate within healthcare facilities. You will guide members through their healthcare journey, coordinate with providers, and promote quality outcomes while ensuring policy compliance and utilization guidelines.

The LO role emphasizes exceptional member experience, timely benefit utilization, and collaboration with hospital staff to optimize care pathways across admission, treatment, and discharge stages.