Remote Member Navigator: Care Access & Support

Vālenz Health®; Phoenix (AZ); Remote; USD 42,000 - 56,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K with company match

Paid time off

Flexible working environment

Employee discounts

Remote-work setup provided

Job summary

Vālenz Health® is hiring a Member Navigator to act as the primary non-clinical contact for members, guiding them through programs and services. You’ll document case details, coordinate scheduling for imaging and services, and collaborate with clinical teams to resolve issues and ensure timely access to care.

You’ll educate members on benefits, gather required information, and maintain accurate CRM records while meeting quality, productivity, and service targets.

Qualifications

• 2+ years of experience in a remote, call center environment.
• High-school diploma or GED required; Associate’s degree is a plus.
• Experience in healthcare scheduling, patient access, or related operations.
• Strong attention to detail while maintaining courteous, timely communication.
• Ability to work independently within given instructions and processes.
• Proficient in Microsoft Office, especially Excel and PowerPoint.

Responsibilities

• Serve as a primary point of contact for members via phone and email with professional, compassionate support.
• Educate members about programs, benefits, eligibility, services, and next steps.
• Gather and document demographic, eligibility, benefit, and service information for cases.
• Research questions using systems and guidelines; resolve routine issues and escalate complex matters.
• Coordinate end-to-end scheduling for imaging and other services; confirm details with members and providers.
• Collaborate with Case Management and clinical teams when clinical review is needed.
• Manage member cases through resolution, with follow-up and next steps.
• Document all interactions and scheduling info in CRM and case management systems.
• Foster clear communication among members, providers, clients, and internal teams.
• Build relationships with provider facilities and external partners.
• Identify service issues or barriers and act to resolve within procedures.
• Assist with claims-related, administrative tasks as needed.
• Meet quality, productivity, and service level targets.
• Maintain knowledge of programs and cross-train across workflows.
• Adapt across programs, queues, and work types as volume requires.
• Collaborate to improve workflows and member experience.
• Perform other duties as assigned.

Skills

Call center experience

Customer service

Verbal and written communication

Attention to detail

Independent work

Education

High school diploma or GED

Associate’s degree (preferred)

Tools

Microsoft Excel

PowerPoint

Job description

Vālenz Health® is hiring a Member Navigator to act as the primary non-clinical contact for members, guiding them through programs and services. You’ll document case details, coordinate scheduling for imaging and services, and collaborate with clinical teams to resolve issues and ensure timely access to care.

You’ll educate members on benefits, gather required information, and maintain accurate CRM records while meeting quality, productivity, and service targets.