- Experience
- 2+ yrs
- Salary
- —
- Openings
- 1
- Posted
- 3 weeks ago
- Work mode
- Work from home
- Education
- Associate degree
- Eligibility
- Candidates with customer service experience, especially outbound call experience, and clinical setting exposure are encouraged to apply. Applicants should be able to work remotely, attend occasional on-site training, and travel to quarterly Chattanooga meetings if they live within driving distance.…
- Resume
- Required to apply
Job description
Role overview
BlueCross BlueShield of Tennessee is seeking a Health Navigator to guide members through their healthcare needs. In this role, you will help people understand their benefits, identify and close gaps in care, and connect them with the services and resources that can improve their health outcomes. The position is centered on outbound member outreach, allowing you to proactively engage individuals, build trusted relationships, and support them throughout their care journey. You will also help reduce barriers by arranging appointments, finding providers, and directing members to suitable programs, while partnering with a team focused on better individual and community health.
Work setup and schedule
This is a remote role with occasional on-site training. For candidates within driving distance, quarterly meetings are held in Chattanooga. The regular work schedule is Monday through Friday, 9:00 a.m. to 6:00 p.m. EST.
Key responsibilities
- Make educational phone calls to explain available benefits, services, and programs, complete health needs assessments, and refer members to population health management programs when appropriate.
- Contact members who have care gaps, encourage follow-through on needed care, and assist with provider searches and appointment scheduling.
- Handle system work queues, review member eligibility, prior case activity, recent claims, customer service contacts, and authorization history, then route members to the clinical team for outreach and intervention when needed.
- Investigate questions and complaints related to processes, designations, lost incentives, and other program-related issues.
- Be available for overtime when business needs require it.
- Meet any required immunizations and/or related medical testing for the role.
- Complete a digital literacy assessment as part of the hiring process.
What the employer is looking for
The ideal candidate brings solid customer service background, especially in outbound call environments, along with experience in a clinical setting. You should be comfortable working on your own, stay patient and adaptable, understand medical terminology, and be willing to use new technology, including AI-enabled tools. The role also calls for strong communication, organization, problem-solving, and time management skills, plus the ability to manage multiple priorities effectively.
Education and experience
An associate degree in education, communication, a health-related field, or equivalent work experience is preferred. At least 2 years of experience in a customer service support role is required.
Additional information
Worker type: Employee. This position reflects a workplace culture that supports innovation and continuous learning, including the use of AI-enabled tools to improve member service. The company states that it does not discriminate in hiring or employment practices. BlueCross BlueShield of Tennessee also notes that unsolicited assistance from search firms for this opening will not be accepted unless a valid written direct placement agreement is already in place.
Number of openings
1