Member Experience Navigator

Careers With Purpose

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.

Facility: Gss National Campus
Location: Sioux Falls, SD
Address: 4800 W 57th St, Sioux Falls, SD 57108, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $19.00 - $30.50

Job Summary

Sanford Health Plan's Health Navigator provides high touch, member centered support in navigating the health care system and health resources. A Health Navigator serves as a single point of contact and liaison to help members maximize their benefits and realize the value of being a Sanford Health patient and Sanford Health Plan member. Health Navigators triage and research individual member situations to ensure they receive the best experience and care. They establish trust and provide support through outreach initiatives including the time during the member's onboarding experience. They collaborate with different resources when necessary. They complete follow up after connecting members to resources ensuring their needs are satisfied. They consult with other members of the member's healthcare team to problem solve and seek advice. They provide superior customer service that is consistent with policies, Sanford values, quality standards and service commitments. Serves as initial point of contact between members and Sanford Health Plan by making outbound, welcome calls to members. Assists members in completing their Health Risk Assessment and connects them with Health Guides, Social Work, and Care Management resources as needed. Works with providers and facilities to prioritize and schedule appointments. Consults with and connects members to appropriate departments to assist and provide members with a clear understanding of health care billing transactions.

Complies with established auditing criteria for interactions. Stays current on policies and procedures to provide accurate information. Maintains the confidentiality of members' personal information to be compliant with confidentiality policies. Maintains customer record with proper notation and detailed comments. Informed of all Sanford Health Plan products, including covered/not covered services, as well as new plan designs, modifications and documentation updates. Informed of Sanford Health resources and connecting points. Provides seamless transition and transfer as needed to ensure continuation of care and service. Performs follow-up and regular check-ins with members to ensure they are receiving the best care and experience. Performs other relevant duties deemed necessary to achieve department and system-wide goals. Works within defined parameters to identify work expectations and quality standards, but is empowered to prioritize the member's needs, and works under minimal direction. Maintains a good team rapport with various departments and personnel across the system to resolve member questions. Demonstrates helpful, friendly, positive attitude and provides the highest level of customer service to each member in a courteous, respectful, and confidential manner.

Qualifications

High school diploma or equivalent required; bachelor's degree preferred

Minimum of three (3) years of customer service or similar position experience required.

Benefits

Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call View phone number on click.appcast.io or send an email to View email address on click.appcast.io .

Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0262418
Job Function: Customer Support Services
Featured: No