Personal Health Advocate (Registered Nurse)

Health Advocate is the nation’s leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need.

Registered Nurse - Personal Health Advocate Your Mission: What Success Looks Like Your primary accountability is to deliver high-quality, member-centered clinical advocacy while meeting service, quality, and case management standards. Work Schedule: Monday-Friday 11am-7:30pm EST. OR 12:30pm-9:00pm EST. Pay: $37 per hour

Member Advocacy & Clinical Guidance: Receive inbound member calls related to a wide range of healthcare issues (e.g., infertility, chronic disease, medications, diagnoses) Assess needs and determine the best course of action while adhering to established policies, procedures, and performance indicators (KPIs) Take ownership of member cases by going beyond the initial request and encouraging continued engagement Education, Trust & Relationship-Building: Educate members on their medical conditions, diagnostic testing, test results, and available treatment options Explain complex medical and benefit-related information clearly and compassionately Build trusted relationships that empower members to actively participate in their healthcare decisions Care Coordination & System Navigation: Provide members with options for healthcare providers and services based on clinical needs, geographic location, and benefit coverage Research providers through credentialing, education verification, and affiliations with recognized medical centers Facilitate communication between members, treating physicians, and insurance carriers Assist with scheduling and re-scheduling appointments, transferring medical records, resolving access issues, and clarifying benefit provisions Intercede on behalf of members to obtain earlier appointments or remove barriers to care Support members with prescriptions, pre-service fee negotiations, and authorization-related challenges Case Management, Documentation & Follow-Up: Maintain accurate, timely documentation using approved case management systems and procedures Place outbound follow-up calls when issues cannot be resolved during the initial interaction Respond to delegate box, answer service, and after-hours calls as required Escalate cases appropriately and on a timely basis to supervisors or internal clinical resources Strong technical proficiency. You are comfortable navigating multiple systems, documenting in case management platforms, and using technology to work efficiently in a fully remote healthcare environment. You adapt quickly to new tools and maintain accuracy while managing digital workflows. Professional Growth & Team Contribution: Stay current on patient care procedures, diagnoses, authorizations, denials, and evolving healthcare practices Mentor and support new team members as needed Collaborate with colleagues to maintain service excellence and balanced workflows Related Duties as Assigned: This job description describes the general nature and level of work performed and is not intended to be a comprehensive list of all activities, duties, or responsibilities. Job incumbents may be asked to perform other duties as required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions outlined above. Please contact your local Employee Relations representative to request a review of accommodations.