Communities Member Care Advocate - Bilingual

Communities Care Coordinators, who are our most visible representatives of our mission to raise the standard of healthcare for everyone, are responsible for providing personalized service, via phone and chat, to Included Health members to connect them with high quality, culturally affirming providers; answer their healthcare benefits questions; initiate healthcare services on their behalf; and assist them with navigating the complexities of the healthcare system.

• Answers in-bound telephone calls and virtual chats in a Contact Center environment from members to provide administrative, financial, and clinical support with empathy and respect.
• Own the member's health care journey from start to finish by answering member calls; communicating with members via Phone and Chat; advocating with insurance companies and community healthcare providers to resolve medical billing problems; and researching available benefits in order to identify the optimal resolution for the member.
• Clearly, timely, and comprehensively collect, capture and document information gained in member interactions, including, but not limited to, demographic and insurance information.
• Contribute to the provider directory by researching and contacting providers to ask a series of questions to collect comprehensive data about their practice and to evaluate if the provider is high-quality and provides culturally competent & affirming care.
• Serves as the liaison between Included Health, its clinicians, and members by supporting and promoting clinical services to members.
• Follows set processes, procedures, and workflows in assisting members with:
• Advocates and navigates member, including finding new providers for members and assisting with locating resources and addressing Social Determinants of Health
• Educate members on their benefits coverage, including, but not limited to, when to consider utilizing their benefits, and how to leverage their benefits
• Triages/supports claims and billing inquiries, prior authorizations, and other support questions.
• Connects members to IH clinical services, including virtual care services, second opinions, etc.
• Upholds IH's mission of raising "The Standard of Healthcare for Everyone"
• Embodies the IH Values and fully understands its services, including:
• Drive strong outcomes in the areas of Member Experience, Scale and Value.
• Collaborates with other Care Coordinators, Leadership, and other departments on specific member healthcare journeys.

• Exceptional business writing skills in English and Spanish, including proficiency in spelling and grammar, and excellent verbal skills (you will need to explain our services with confidence and a friendly telephone demeanor).
• Proficiency with Google Apps, Apple Products, and Customer Relationship Management Software is preferred.
• Familiarity and comfortability with Voice-over-IP (VoIP) phone systems (e.g. CXOne) and communicating through such systems for a majority of the work day.
• Bachelor's degree or 2+ years of relevant work experience in healthcare, advocacy, or benefits/insurance organization is highly preferred.
• Excellent customer service skills.
• Exceptional critical thinking and problem-solving skills to assess and resolve complex healthcare situations.
• Successful at handling confidentiality, security, and HIPAA guidelines and regulations.

• Ability to work shifts of at least 8 hours, 5 days per week.
• Ability to work from a dedicated space that is distraction-free, sufficiently HIPAA compliant, and has a secure, high-speed, hardwired internet connection
• Ability to operate in a fast-paced, high-intensity work environment where you will have multiple tasks and priorities to manage in an ever-changing landscape.
• Ability to remain in a stationary position for prolonged periods while utilizing a computer to perform all work duties.
• 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 (e.g., lifting a computer / laptop) may be required.
• Ability to interact with leadership, employees, and members in an appropriate and respectful manner.
• Maintains composure during moments of stress, maintains a helpful disposition at all times, and leverages de-escalation skills and techniques when necessary.
• Ability to exercise good judgment, work effectively under time constraints, prioritize work, multi-task, and adapt to changing work demands.

The United States new hire base salary target ranges for this full-time position are:

Zone A: $20.72 - $26.93 + equity + benefits

Zone B: $22.79 - $29.63 + equity + benefits

Zone C: $24.86 - $32.32 + equity + benefits

Zone D: $26.93 - $35.01 + equity + benefits

This range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone. Below is additional information on Included Health's commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones.

Starting base salary for the successful candidate will depend on several job-related factors, unique to each candidate, which may include, but not limited to, education; training; skill set; years and depth of experience; certifications and licensure; business needs; internal peer equity; organizational considerations; and alignment with geographic and market data. Compensation structures and ranges are tailored to each zone's unique market conditions to ensure that all employees receive fair and competitive compensation based on their roles and locations. Your Recruiter can share details of your geographic alignment upon inquiry.

In addition to receiving a competitive base salary, the compensation package may include, depending on the role, the following:

Remote-first culture

401(k) savings plan through Fidelity

Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)

Full suite of Included Health telemedicine (e.g. behavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependents

Generous Paid Time Off ("PTO") and Discretionary Time Off ("DTO")

12 weeks of 100% Paid Parental leave

Family Building Benefit with fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistance

Compassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment)

11 Holidays Paid with one Floating Paid Holiday

Work-From-Home reimbursement to support team collaboration and effective home office work

24 hours of Paid Volunteer Time Off ("VTO") Per Year to Volunteer with Charitable Organizations

About Included Health

Included 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.

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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.