Member Care Navigator

PacificSource; North Carolina; Hybrid; USD 36,000 - 57,000; Full time

Benefits offered by this job

Flexible telecommute policy

Medical insurance

Vision insurance

Dental insurance

Incentive program

Paid time off and holidays

401(k) plan

Volunteer opportunities

Tuition reimbursement and training

Life insurance

Flexible spending account

Job summary

PacificSource is seeking a Member Support Specialist to work with the case management team, supporting members telephonically and in person. The role focuses on navigating the healthcare system, arranging transportation, and linking patients with resources to improve health outcomes.

Travel ~20% and strong communication are essential. Required: at least three years in community services or healthcare coordination, familiarity with health insurance, and proficiency with Microsoft Office.

Qualifications

• High school diploma or equivalent required.
• Experience in health insurance and delivering group presentations preferred.
• Minimum three years of experience in community services or healthcare agencies focused on coordination services.

Responsibilities

• Develop and implement goals to help members navigate the healthcare system.
• Educate members on benefit structure and resources.
• Use motivational interviewing to engage members in achieving health outcomes.
• Identify community resources and referrals.
• Serve as liaison between members and providers/agencies.
• Coordinate referrals via claims data and internal/external sources.
• Ensure HIPAA compliance and accurate documentation.

Skills

Communication

Collaboration

Accountability

Listening

Organizational skills

Problem solving

Teamwork

Flexibility

Education

High school diploma or equivalent

Job description

PacificSource is seeking a Member Support Specialist to work with the case management team, supporting members telephonically and in person. The role focuses on navigating the healthcare system, arranging transportation, and linking patients with resources to improve health outcomes.

Travel ~20% and strong communication are essential. Required: at least three years in community services or healthcare coordination, familiarity with health insurance, and proficiency with Microsoft Office.