Care Guide Advocate

Supporting both RN Care Coordinators and Utilization Management RNs, the full-time remote Care Guide Advocate will assist members and providers in navigating healthcare processes, ensuring a seamless experience through a blend of administrative, educational, and customer service functions. Key responsibilities Provide exceptional customer service to patients and providers via phone and email, handling difficult situations with empathy Assist members with provider searches and navigation of digital programs, serving as a liaison for escalations and inquiries Contact provider offices for prior authorization needs and assist with claims adjustments while ensuring compliance with privacy regulations Required qualifications High school diploma 2-3 years of experience in customer service Strong computer skills and experience with electronic medical records Intermediate knowledge of Microsoft Windows Ability to work effectively in a fast-paced environment with competing priorities