Virtual Care Advocacy, Tier 1 (January Cohort)

Remote; San Francisco (CA); À distance; USD 52 000 - 76 000; Plein temps

Résumé du poste

Included Health is seeking a Virtual Care Advocate to be the front door of our virtual care services. You will assist members via phone and messaging, help navigate the app, answer healthcare questions, and connect them to the right services based on Health Plan or Client package types.

You will resolve routine issues at first touch, document interactions clearly, and escalate when needed to Technical Support or other teams. Training and ongoing skill development are provided.

Qualifications

• 2+ years in customer service, member support, or healthcare operations.
• Strong verbal and written communication with correct grammar.
• De-escalation, listening, and problem-solving skills.
• Ability to manage multiple workflows and systems accurately.
• Attention to detail in documentation and follow-through.
• Ability to follow defined workflows with sound judgment.
• Comfort in a fast-paced service environment with performance expectations.
• Compassionate, professional, member-first experience.
• Proficiency with web-based systems, smartphones/apps, Google apps, and CRM software.
• Familiarity with VoIP systems like CXone; comfortable on the phone.

Responsabilités

• Serve as a first-contact support advocate for members across Virtual Care and Core interactions.
• Handle inbound calls, messaging, and standard support needs with accuracy, empathy, and urgency.
• Resolve routine virtual-care member issues end to end within Tier 1 scope.
• Gather complete details to understand member needs and determine next steps.
• Document interactions clearly in required systems.
• Use SOPs, knowledge resources, and approved tools to support resolution.
• Create or update cases for Tech support, Quality, VCS, imaging/referral workflows when needed.
• Capture clear case descriptions and escalation details for handoffs.
• Reinforce seamless member experience during handoffs and set expectations.
• Flag recurring issues and workflow gaps to supervisors.
• Suggest improvements based on recurring patterns.
• Maintain confidentiality per HIPAA guidelines.
• Maintain attendance, productivity, and schedule adherence.
• Participate in onboarding and ongoing training.

Connaissances

Customer service

Communication

De-escalation

Problem-solving

Attention to detail

Multi-tasking

HIPAA

Outils

CXone

Hub

Athena

Care App

Description du poste

As a Virtual Care Advocate, you are the front door to virtual care at Included Health functioning much like the front desk of a medical office. You will be the first point of contact for members across phone and messaging channels, helping them navigate our app, answer healthcare questions, and connect them to the right services based on their Health Plan or Client package types.

This team supports multiple areas of the member experience, and is expected to show up fully within the Tier 1 scope to deliver a seamless, member-first experience at every interaction. You will be responsible for resolving member needs at first touch whenever possible, gathering accurate information, and documenting clearly. When a situation requires escalation to another support team, you will identify the appropriate handoff flow whether to Technical Support or downstream teams such as Virtual Care Support, Quality, Imaging or Referrals teams.

Core responsibilities include account in troubleshooting and scheduling support, eligibility and coverage troubleshooting, provider documentation, prescription, lab, imaging and referral status inquiries.

This role is an individual contributor and will report into the Supervisor, Virtual Care Advocacy Operations.

The start date for this role is 1/11.

Responsibilities:

• Serve as a first-contact support advocate for members across Virtual Care and Core interactions.

• Handle inbound calls, messaging, and standard support needs with accuracy, empathy, and urgency.

• Resolve routine virtual-care member issues end to end whenever they fall within Tier 1 General scope.

• Gather complete and relevant details to understand the member’s needs before determining next steps.

• Document interactions clearly, accurately, and completely in required systems.

• Use established SOPs, knowledge resources, workflow guidance, and approved job aids to support issue resolution.

• Use Care App, Athena, Hub, CXone, and other approved tools to complete trained workflows accurately.

• Create or update cases correctly for Tech support, Quality, VCS, imaging/referral, and medical-records-related workflows when required.

• Capture clear case descriptions, troubleshooting steps already taken, and the correct case type, subtype, and channel fields when escalation is needed.

• Reinforce a seamless member experience during handoffs by setting expectations clearly and minimizing friction.

• Flag recurring issues, workflow gaps, or member pain points to supervisors.

• Recommend ways the team can improve the member experience based on recurring support patterns.

• Acknowledge members’ rights on confidentiality issues, maintain member confidentiality at all times, and follow HIPAA guidelines and regulations.

• Maintain quality, productivity, attendance, and schedule adherence expectations.

• Participate in onboarding, training, calibration, and ongoing skill development.

Required Qualifications:

• 2+ years of experience in customer service, member support, advocacy, healthcare operations, or contact center environments, including handling customer or member inquiries via voice and/or chat.

• Strong verbal and written communication skills, including accurate spelling and grammar.

• Strong de-escalation, listening, and problem-solving skills.

• Ability to manage multiple workflows and systems while maintaining accuracy.

• Strong attention to detail in documentation and follow-through.

• Ability to follow defined workflows while applying sound judgment.

• Comfort working in a fast-paced service environment with performance expectations.

• Ability to deliver a compassionate, professional, and member-first experience.

• Proficiency with technology, including web-based systems, smartphones/apps, Google apps, and customer relationship management software.

• Familiarity with VoIP phone systems such as CXone and comfort communicating on the phone for the majority of the workday.

• Ability to learn and apply workflow-specific guidance for virtual care scheduling, eligibility troubleshooting, case creation, provider document handling, Rx/lab status, and imaging/referral support.

Preferred Qualifications:

• Experience in healthcare, virtual care, care navigation, or advocacy support.

• Experience supporting phone-based member interactions.

• Familiarity with documentation standards, case notes, and escalation workflows.

• Experience working across multiple tools and knowledge resources in a live service environment.

• Experience supporting members with complex or sensitive needs.

• Familiarity with Hub, Care App, Athena, CXone, or similar service and workflow systems.

Physical/Cognitive Requirements:

• Prompt and regular attendance at assigned work location.

• Ability to remain seated in a stationary position for prolonged periods.

• Requires eye-hand coordination and manual dexterity sufficient to operate keyboard, computer, and other office-related equipment.

• No heavy lifting is expected, though occasional exertion of about 20 lbs. of force may be required.

• Ability to interact with leadership, employees, and members in an appropriate manner.

About Included HealthIncluded Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com.Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law.