Job Description
Job DescriptionDescription:
Rise Health Services is seeking a compassionate, detail-oriented Health Advocate. This role is ideal for someone who excels in member engagement, enjoys helping others navigate their healthcare needs, and thrives in a fast-paced outreach environment.
As a Health Advocate at Rise Health Services, you will serve as a key point of contact for our members — particularly those under value-based care or care-management programs. Your role is to engage members via inbound and outbound calls to help coordinate preventive care, routine screenings, medication adherence, appointments, and overall health maintenance. Through effective communication, guidance, and follow-up, you will help improve health outcomes, close care gaps, and support the organization’s quality and payer performance goals.
Key Responsibilities:
Member Outreach & Engagement
- Make outbound calls to members to schedule preventive care (screenings, wellness visits, immunizations), follow-up appointments, and medication refills.
- Handle inbound calls from members seeking assistance, guidance, or support regarding their benefits, coverage, or care coordination.
- Educate members about their health benefits, preventive care recommendations, and available resources.
Care Gap Closure & Quality Support
- Assist members in closing care gaps tied to quality and value-based metrics (e.g., preventive screenings, chronic-care management, immunizations).
- Track and follow up on member care plans, ensuring services are scheduled and completed.
- Document all member interactions, outcomes, follow-up needs, and care coordination steps accurately in the system.
Coordination with Providers & Internal Teams
- Communicate with providers’ offices, clinics, pharmacies, or other partners to facilitate appointments, referrals, or service access as needed.
- Escalate complex issues to clinical or care-management teams when additional intervention or support is required.
Member Advocacy & Support
- Help overcome barriers to care — logistical, behavioral, educational, or coverage-related.
- Offer empathetic, member-centered support; build trust and rapport while ensuring professionalism.
Reporting & Metrics Tracking
- Maintain call logs, outreach records, outcomes, and relevant data within CRM/EHR or care-management systems.
- Assist in producing reports or dashboards tracking outreach results, care-gap closure rates, preventive care compliance, and quality-related metrics.
- Support periodic audit or quality reporting requirements as needed.
Compliance & Confidentiality
- Handle protected health information (PHI) in compliance with HIPAA and organizational privacy policies.
- Follow company guidelines for documentation, data security, and member privacy.
Requirements:
Preferred Qualifications & Skills
- High school diploma or GED required; Associate’s or Bachelor’s degree in Healthcare Administration, Public Health, Social Work, or related field preferred.
- 1–3 years (or more) experience in call center, member services, care coordination, or related healthcare outreach roles — ideally within value-based care or managed care environments.
- Excellent verbal and written communication skills; strong active listening and customer service orientation.
- High proficiency in computer use — comfortable with EHR/CRM systems, web-based applications, telephony systems, and data entry.
- Empathy, professionalism, patience, and ability to work sensitively with potentially vulnerable or elderly populations.
- Strong organizational skills, reliability, and the ability to manage multiple tasks and follow-ups.
- Ability to work from a remote workspace: stable wired internet, quiet and private work area, reliable phone/ headset setup (if remote).
Work Environment & Expectations
- Remote-friendly position (subject to verification of internet/telecom requirements and workspace suitability).
- Fast-paced, target-driven environment with outreach and follow-up metrics.
- Work may include outreach primarily during business hours; schedule may include flexible shifts or periodic overtime depending on program needs and member availability.
- Regular monitoring of quality and performance metrics, with expectations for documentation accuracy and member satisfaction.
Why Join Rise Health Services
- Opportunity to make a meaningful difference by helping members access necessary care, close care gaps, and improve health outcomes
- Work in a value-based care environment, supporting quality metrics and population health initiatives
- Remote-eligible role offering flexibility
- Chance to grow within a dynamic healthcare services company as care coordination and value-based care continue to expand
Compensation & Benefits
- Competitive Pay
- Medical, dental, life and vision insurance.
- Paid time off (PTO), holidays, and flexible scheduling options.