• Member Experience Navigator - Health Plan

    Sanford Health (Sioux Falls, SD)


    Careers With Purpose

     

    Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

     

    **Facility:** GSS National Campus

    **Location:** Sioux Falls, SD

    **Address:** 4800 W 57th St, Sioux Falls, SD 57108, USA

    **Shift:** Varies

    **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 Health 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 https://sanfordcareers.com/benefits .

     

    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 1-877-673-0854 or send an email to [email protected] .

     

    Sanford Health 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-0220559

    **Job Function:** Customer Support Services

    **Featured:** No