Care Guide

Join Us in Shaping the Future of Health Care At MVP Health Care, we’re on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference—every interaction, every day. We’ve been putting people first for over 40 years, offering high-quality health plans across NewYork and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not‑for‑profit, we invest in what matters most: our customers, our communities, and our team. What’s in it for you: Growth opportunities to uplevel your career A people‑centric culture that celebrates diverse perspectives, backgrounds, and experiences Competitive compensation and comprehensive benefits focused on well‑being An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work About the Opportunity As a Care Guide at MVP Health Care, you will play a crucial role in enhancing our members' healthcare experience. You will support a customer’s care journey during their time with MVP through high‑quality interactions and experiences. The Care Guide works directly with customers and, as appropriate, with customers’ family and/or advocates to ensure they have a smooth transition to their plan and fully understand the benefits and resources available to them as they use the plan. The Care Guide collaborates with Plan Guides during the sales processes to provide deep benefit and product knowledge, guiding prospective customers to their best plan options and serving as the escalation and transition point for customers with clinical needs to Care Management. The role also includes connecting customers to resources that support, promote, and facilitate engagement in MVP programs that support health and wellbeing. Regardless of the intersection points with the plan, the Care Guide coordinates ongoing needs, collaborates with multidisciplinary teams, and aids member’s onboarding. They act as a liaison, facilitating engagement with the plan and coordination with Provider Partners in each of MVP’s regions, helping members reduce or resolve challenges and barriers so that members can achieve optimal health, independence, safety, and wellbeing. The Care Guide develops meaningful relationships, expands knowledge of MVP products, and serves as the bridge between customers, the health plan, and providers to create a seamless, positive experience. The Care Guide also manages and resolves highly complex, non‑routine customer issues, supports Plan Guides and other Customer Care staff, and demonstrates MVP core values in all interactions. By building individual capacity, the Care Guide enhances health and wellness self‑management skills through outreach, education, informal counseling, social supports, and advocacy. They empower customers to make informed decisions, advocate on their behalf when necessary, and provide support for future questions about care, benefits, and system coordination. Qualifications you’ll bring Associate’s degree in a health or human services field or equivalent Minimum of 3 years successful experience working within a managed care or health services environment Experience in customer service and understanding and responding to customer needs Experience in Managed Care and/or working relationships with Medicare, Medicaid, or Social Service Agencies (a plus) Experience in positions where adhering to strict confidentiality and implementing process improvements is required Ability to empathize and “be in the shoes” of MVP members, understand how issues impact them, and act as a member advocate Willingness to meet directly with members, their families, or advocates in office, home settings, or other warranted locations Commitment to high ethical standards in all work Protects the privacy of member and MVP data and exercises discretion in handling confidential member information Deep knowledge of Medicare, Medicaid, Commercial programs and products and understanding of the current health care market and available community resources Ability to collaborate with the team to assist and resolve customer concerns and complaints Strong verbal and written communication and interpersonal skills Excellent ability to communicate independently and directly with customers, providers, and staff with calmness, assertiveness, diplomacy, and a nonconfrontational manner Ability to incorporate Evidence‑Based Innovation (EBI) practices into day‑to‑day customer engagement Demonstrated organizational skills, accountability, and personal ownership of work Excellent problem‑solving and analytical skills Ability to identify trends, interpret information, and draw conclusions from incomplete data Your key responsibilities Complete new customer welcome calls and support their transition to the plan Provide ongoing information and assistance to customers to support accessing MVP programs, including connection with clinical programs and care management resources Build enduring relationships with customers Orient new members to specific product offerings and the services of the role Ensure customers have a significant understanding of their benefits and eligibility for certain services, and coordinate transition of care items Assist customers in addressing unmet needs beyond standard benefit coverages Facilitate reduction of care disruption or delays, and connect to clinical programs and Care Management resources Facilitate access to culturally appropriate services that meet the customer’s stated needs and enhance service quality Promote knowledge of the health delivery system(s) to empower customers Collaborate with MVP Quality Management to support performance measurements Address other service needs as they arise from customers Accountable for resolution of highly complex customer issues Facilitate resolution of real and perceived disruptions of care as customers enroll in MVP Medicare Advantage Participate in cross‑departmental and external meetings supporting customers, including with Care Pods and provider partners Attend in‑person events with Plan Guides at MVP events to support prospective customer inquiries Engage on‑site with customers at MVP offices, community events, provider offices, etc. Where you’ll be Location: Hybrid Pay Transparency: MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range for this role is $51,395.00 – $68,354.75. MVP adheres to pay transparency nondiscrimination principles and offers compensation based on location, experience, education, and demand. Equal Employment Opportunity Statement MVP Health Care is an equal‑opportunity employer. We recruit, employ, train, compensate, and promote without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam‑era or special disabled Veteran or other legally protected classifications. To support a safe, drug‑free workplace, pre‑employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at View email address on click.appcast.io. #J-18808-Ljbffr LE12 MVP Service Corp.