Care Access Champion: Member Health Navigator

Molina Healthcare; California (MO); On-site; USD 18,000 - 40,000; Full time

Benefits offered by this job

Competitive benefits package

Equal Opportunity Employer

Job summary

Molina Healthcare is seeking a Member Navigator to provide telephonic liaison support for members navigating health care needs. You will identify barriers, connect resources, and help ensure quality, cost-effective care while adhering to program guidelines.

Responsibilities include scheduling, data updates, and collaboration across departments to resolve issues promptly. This role emphasizes KPI performance and member-focused service.

Qualifications

• At least 2 years in customer service, preferably healthcare.
• Strong problem-solving and organizational skills.
• Ability to prioritize and manage multiple tasks.
• Knowledge of medical/pharmacy terminology and NCQA guidelines.
• Ability to collaborate with members, providers and leadership.
• Strong verbal and written communication and professional phone etiquette.
• Proficiency with Microsoft Office; ability to learn new software.

Responsibilities

• Serve as member liaison throughout the program life cycle and provide resources.
• Communicate with members and caregivers to uncover and act on barriers to outcomes.
• Schedule, confirm, and remind appointments; mail letters as needed.
• Identify and connect members to resources addressing SDOH.
• Notify departments of data related member case updates.
• Enter and update data; participate in huddles and meetings.
• Prepare case status summaries and escalation communications to leadership.
• Meet KPI metrics as defined by leadership.

Skills

Customer service

Problem-solving

Critical thinking

Organizational skills

Multitasking

Communication skills

Microsoft Office

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Member Navigator to provide telephonic liaison support for members navigating health care needs. You will identify barriers, connect resources, and help ensure quality, cost-effective care while adhering to program guidelines.

Responsibilities include scheduling, data updates, and collaboration across departments to resolve issues promptly. This role emphasizes KPI performance and member-focused service.