Sharecare is looking for a Family Health Advocate to provide remote support, guiding members and their families through personalized healthcare navigation and resource facilitation. Driven by our philosophy that we are all together better, we are committed to making high-quality care more accessible and affordable for everyone.
What You'll Do
- Answer member inquiries via voice and chat regarding eligibility, benefits, claims, ID cards, grievances/appeals, and utilization management status.
- Perform provider searches focused on cost and quality and present premier provider options.
- Provide support for spending accounts, pharmacy, disability, incentives, rewards, and durable medical equipment (DME) ordering.
- Conduct community resource searches and manage member preferences.
- Coordinate issue resolution with providers, payers, or third parties for claims adjustments, grievances, appeals, utilization management intake, and complex pharmacy or spending account inquiries.
- Provide proactive care guidance for closing care gaps, benefits education for procedures, and preparing members for scheduled procedures and admissions.
- Refer members to available third parties for care management, second opinions, or to Clinical Advocates (Nurses) for clinical care needs.
- Understand and communicate benefit design packages to members as defined by employer.
- Interact with members verbally and in writing to ensure appropriate engagement.
- Explain plan benefit design and handle benefit and enrollment issues.
- Drive member engagement into appropriate programs and offerings.
- Educate members on healthcare-related inquiries.
What We're Looking For
- High school diploma or GED.
Nice to Have
- 2-year associate's degree in healthcare/health sciences OR equivalent experience in healthcare, preferably helping members navigate benefits and claims.
- Experience in customer service in a healthcare contact center, provider office, or healthcare institution.
- Experience in successful resolution of high-level or sensitive customer service issues.
Work Mode
This is a fully remote position.
Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.
