Health Plan Navigator
Health Plan Navigator
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Job Description
Employment Type:
Full timeShift:
Day ShiftDescription:
Be the Guide Who Makes Healthcare Easier to Navigate
Healthcare can be complexbut with the right support it doesnt have to be. As aColleague Health Plan Navigator youll be the trusted partner our health plan members turn to when they need help understanding their care options finding the right providers or overcoming barriers to access. You wont just answer questionsyoull build relationships solve problems and help people feel confident in their healthcare journey.
This is more than a support roleits a chance to make a meaningful impact every day by improving care experiences reducing fragmentation and promoting better health outcomes across our organization.
About the Role
As aHealth Plan Navigator youll be the go-to resource for members of the Trinity Health Colleague Health Plan. Youll guide them through the healthcare system connect them with the right providers and services and help ensure they receive high-quality cost-effective care. Youll work closely with members their support networks and healthcare providers to reduce care fragmentation and improve outcomes.
What Youll Do
Serve as a trusted guide for health plan members helping them access care and understand their options.
Connect members with primary care providers specialists and community resources.
Educate members on appropriate care settings (e.g. urgent care vs. ER) and available support tools.
Identify trends and barriers in care access and collaborate with the team to improve services.
Support providers with insights and feedback to enhance the member experience.
Act as a point of escalation for member concerns related to access or care quality.
Maintain up-to-date knowledge of healthcare regulations and Trinity Health policies.
What You Bring
Education & Experience:
Bachelors degree in Human Resources Nursing Marketing or a related field (or an equivalent combination of education and experience).
At least 3 or more years of relevant work experience with health plans provider networks and/or medical group practices.
In-depth knowledge and understanding of healthcare systems and applicable laws/regulations (e.g. HIPAA).
Skills & Abilities:
Excellent communication and relationship-building skills.
Strong problem-solving and analytical thinking.
Proficiency in Microsoft Office (especially Excel Word PowerPoint).
Ability to work independently and collaboratively in a fast-paced environment.
High level of discretion and professionalism with sensitive information.
Bonus Points If You Have
Knowledge of chronic conditions preventive care and patient education.
Experience with employer-sponsored health plans or working in a provider network.
Why Join Saint Alphonsus
At Saint Alphonsus we live our mission every day: to serve together in the spirit of the Gospel as a compassionate and transforming healing presence. Youll be part of a supportive values-driven team thats making a real difference in peoples lives.
Our Commitment
Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.
Employment Type
Full-Time
