
Personal Health Advocate
- medical terminology
- Microsoft Word
- Excel
- HIPAA
Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Ā Join our award winning team!
2025:
StevieĀ® Awards for Sales & Customer Service:Customer Service Department of the Year ā Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
2024:
Excellence in Customer Service Awards: Organization of the Year (Small)
StevieĀ® Awards for Sales & Customer Service:Customer Service Department of the Year ā Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
Best in Biz Awards: Most Customer-Friendly Company of the Year ā Medium and large category (Silver)
As part of Teleperformance in the US, we were also named #95 in the 2024 āFortune 100 Best Companies to Work ForĀ®ā in the USA by Great Places to Work (GPTWĀ®)
**EVENING SHIFTS**
Your Mission: What Success Looks Like
Your primary accountability andPersonal Health Advocate, Registered Nurse is to deliver high-quality, member-centered clinical advocacy while meeting service, quality, and case management standards.Ā
Success in this role includes consistently achieving:Ā
š¹ Member Advocacy & Clinical GuidanceĀ
Receive inbound member calls related to a wide range of healthcare issues (e.g., infertility, chronic disease, medications, diagnoses)Ā
Assess needs and determine the best course of action while adhering to established policies, procedures, and performance indicators (KPIs)Ā
Take ownership of member cases by going beyond the initial request and encouraging continued engagementĀ
š¹ Education, Trust & Relationship-BuildingĀ
Educate members on their medical conditions, diagnostic testing, test results, and available treatment optionsĀ
Explain complex medical and benefit-related information clearly and compassionatelyĀ
Build trusted relationships that empower members to actively participate in their healthcare decisionsĀ
š¹ Care Coordination & System NavigationĀ
Provide members with options for healthcare providers and services based on clinical needs, geographic location, and benefit coverageĀ
Research providers through credentialing, education verification, and affiliations with recognized medical centersĀ
Facilitate communication between members, treating physicians, and insurance carriersĀ
Assist with scheduling and re-scheduling appointments, transferring medical records, resolving access issues, and clarifying benefit provisionsĀ
Intercede on behalf of members to obtain earlier appointments or remove barriers to careĀ
Support members with prescriptions, pre-service fee negotiations, and authorization-related challengesĀ
š¹ Case Management, Documentation & Follow-UpĀ
Maintain accurate, timely documentation using approved case management systems and proceduresĀ
Place outbound follow-up calls when issues cannot be resolved during the initial interactionĀ
Respond to delegate box, answer service, and after-hours calls as requiredĀ
Escalate cases appropriately and on a timely basis to supervisors or internal clinical resourcesĀ
š¹ Professional Growth & Team ContributionĀ
Stay current on patient care procedures, diagnoses, authorizations, denials, and evolving healthcare practicesĀ
Mentor and support new team members as neededĀ
Collaborate with colleagues to maintain service excellence and balanced workflowsĀ
Who You Are: The Leader Weāre Looking ForĀ
You are an experienced nurse who bringsclinical judgment, composure, and accountability to every interaction.Ā
You naturally demonstrate:Ā
Ownership and follow-throughĀ
You take responsibility for member outcomes and see cases through with care and precision.Ā
Empathy grounded in professionalismĀ
You listen deeply and respond with compassion while maintaining clarity, confidence, and appropriate boundaries.Ā
Strong critical thinkingĀ
You quickly synthesize clinical information, prioritize what matters, and determine effective next steps.Ā
Clear and confident communicationĀ
You explain complex medical and insurance concepts in a way members can understand and trust.Ā
A commitment to quality and resultsĀ
You are motivated by accuracy, meaningful resolution, and delivering an exceptional member experience.Ā
Curiosity and continuous learningĀ
You stay current on healthcare trends, systems, and procedures to provide thoughtful, informed guidance.Ā
Who Will Thrive in This RoleĀ
You will thrive in this role if you are comfortable balancing compassionate member conversations with a fast-paced, high-volume phone environment. This is a strong fit for someone who can stay organized, document thoroughly and in real time, follow cases through to resolution, and maintain a calm, professional presence while managing multiple member needs throughout the day.Ā
Minimum QualificationsĀ
EducationĀ
BSN or RN degree from an accredited college or university (required)Ā
LicensureĀ
Active and unrestricted State or Multi-State Registered Nurse license (required)Ā
ExperienceĀ
Minimum 3ā5 years of clinical and/or medical management experienceĀ
Behavioral and/or mental health experience is strongly preferred, especially experience supporting members through sensitive, complex, or emotionally charged healthcare situations.Ā
Core SkillsĀ
Strong understanding of medical terminology and healthcare systemsĀ
Excellent verbal communication skills and professional phone presenceĀ
Ability to explain complex healthcare topics to diverse populationsĀ
Highly effective listening, problem-solving, and issue-resolution skillsĀ
Strong organizational and administrative abilitiesĀ
Proficiency with Microsoft Word and ExcelĀ
Ability to work effectively in a collaborative, remote team environmentĀ
Team Interface & Customer ServiceĀ
Establish and maintain professional relationships with internal and external customersĀ
Collaborate with team members to meet departmental goalsĀ
Deliver customer service that consistently exceeds expectationsĀ
Treat all individuals with dignity, respect, and professionalismĀ
Escalate workflow or communication issues to leadership as appropriateĀ
PLEASE NOTE: This role offers $37 per hour and is forevening hours:
12-8:30 pm EST.
12:30-9 pm EST.
1-9:30 pm EST.
Mental and Physical RequirementsĀ
This position is fully remote and requires a dedicated, HIPAA-compliant workspace with reliable internet access.Ā
The nature of the work is sedentary, involving prolonged sitting and continuous computer and phone use. Essential functions include repetitive motion, typing, concentration, reading, and ongoing verbal and written communication throughout the workday.Ā
Related Duties as AssignedĀ
This job description describes the general nature and level of work performed and is not intended to be a comprehensive list of all activities, duties, or responsibilities.Ā
Job incumbents may be asked to perform other duties as required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions outlined above.Ā
Please contact your local Employee Relations representative to request a review of accommodations.Ā
Why Health Advocate?Ā
Because here, nursing expertise drives impact.Ā
Youāll join an organization that values structure, autonomy, accountability, and compassion ā where your clinical judgment directly improves the lives of the members you serve.Ā
Company Overview
Health Advocate is the nationās leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need.
Learn more
Health Advocatehttps://www.healthadvocate.com/site/
Facebookhttps://www.facebook.com/healthadvocateinc/
Videohttps://vimeo.com/386733264/eb447da080
Awards:
2025:
StevieĀ® Awards for Sales & Customer Service:Customer Service Department of the Year ā Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
2024:
Excellence in Customer Service Awards: Organization of the Year (Small)
StevieĀ® Awards for Sales & Customer Service:Customer Service Department of the Year ā Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
Best in Biz Awards: Most Customer-Friendly Company of the Year ā Medium and large category (Silver)
2023:
National Customer Service Association All-Stars Award: Service Organization of the Year.
StevieĀ® Awards for Sales & Customer Service: Customer Service Department of the Year ā Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
2022:
StevieĀ® Awards for Sales & Customer Service: Customer Service Department of the Year ā Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
Excellence in Customer Service Awards: Organization of the Year (Small)
Best in Biz Awards: Most Customer-Friendly Company of the Year ā Medium and large category (Silver)
2021:
StevieĀ® Awards for Sales & Customer Service: Customer Service Department of the Year ā Healthcare, Pharmaceuticals, and Related Industries, Silver Winner
StevieĀ® Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner
Best in Biz Awards: Most Customer-Friendly Company of the Year ā Medium and large category (Silver)
2020:
National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up
Communicator Award of Distinction: October 2019 Broker News
MarCom Awards: Gold, COVID Staycation Ideas brochure
MarCom Awards: Platinum, 2021 Well-being Calendar
Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver)
VEVRAAĀ Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans.
PAY TRANSPARENCY NONDISCRIMINATION PROVISION
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractorās legal duty to furnish information. 41 CFR 60-I.35(c)
Personal Health Advocate Ā· Health Advocate Solutions, Inc.