Health Advocate

Careers About Health Advocate

If you're an experienced professional seeking a position with a dynamic, rapidly growing company that provides a highly personalized and caring service, you've come to the right place.

Health Advocate, the nation’s leading healthcare advocacy and assistance company, and subsidiary of West Corporation, serves millions of members through our extensive client relationships with employers and other plan sponsors. We help members throughout the country deal with issues they encounter while accessing the healthcare and insurance systems. The company, headquartered in suburban Philadelphia with field sales offices around the country, offers a broad spectrum of cost-effective advocacy and assistance solutions, enabling employers of all sizes, employees and their families to more easily navigate the complexities of the healthcare world.

Salary and Benefits

Health Advocate offers a competitive benefits package including health and wellness benefits, 401k plan as well as opportunities for career growth and development.

EEO Statement

Health Advocate is an equal opportunity employer.

As a rapidly growing company and as one of Philadelphia magazine’s “Top 20 Best Places to Work,” we are frequently asked for details about potential job openings. In an effort to inform, listed below are descriptions of many of our positions. Theopenindicates we are actively looking to fill that position.

About Health Advocate
Account Coordinator
open

Description

Health Advocate is seeking a Wellness Account Coordinator in the Plymouth Meeting office to support the Wellness Consultants and Operations teams in the wellness division. You must be a go getter with a roll-up-your-sleeves mentality, process-oriented, detail-oriented, tech savvy, highly analytical, a team player, organized, and self-motivated. In addition, you need to have excellent relationship building skills, outstanding communication skills, a strong work ethic, positive attitude and, most definitely, a sense of humor.

The Wellness Account Coordinator will support the Wellness Consultants and Operations team with day to day operational needs, including back-end implementation of clients (entering them into our databases, setting up website), running and analyzing client utilization reports, and ensuring all client data is accurate and up-to-date. The intent is to assist in delivering the highest quality service while adhering to the mission and goals Health Advocate has established to provide best in class wellness services to its clients.

Responsibilities Include:

  • Assist with new client implementations, including entering new clients on company CRM and website administration tool, and QA’ing other set-ups
  • Generate, test, and analyze client utilization reports
  • Correspond with clients via email and phone
  • Provide customer service support to employees of our clients using Salesforce.com
  • Ensure account data is accurate and up to date in Salesforce.com
  • Work with a team which fosters the delivery of high quality services and promotes exceptional customer service
  • Aid Wellness Consultants with communications, promotions and educational materials
  • Other client operations and client support tasks on an as-needed basis

Qualifications

Desired Skills, Experience & Interests

Required:

  • BA/BS
  • Interest in corporate wellness industry
  • Ability to work independently and with a team
  • Problem solver
  • High level of self-initiative
  • Experience working in a professional environment
  • Experience working with clients
  • Comfortable using Microsoft office suite, especially Excel
  • Comfortable navigating the internet
  • You consider yourself tech-savvy

Preferred but not required background:

  • Experience in the health insurance, human resources, corporate wellness, or similar industry
  • Experience using Salesforce.com

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Applications Developer
open

Description

Health Advocate is seeking a highly qualified candidate for the position of Applications Developer. The ideal candidate will be a bright, clear-thinking problem solver with expertise in web application technologies and also demonstrates an understanding of relational databases and reporting technologies. Specifically, you will be responsible for designing and developing internal and external web-based applications and web sites that support our product vision or improve operational efficiencies.

Requirements

  • Analyze business requirements and transform them into technical design
  • Using appropriate tools, design, build and enhance externally facing web sites using primarily ASP.NET and related technologies
  • Create standards-compliant, cross-browser-compatible HTML & CSS from visual designs with pixel-level accuracy and attention to detail
  • Provide support for existing web sites that support the business
  • Proactively provide ideas and solutions towards the improvement of business operations

Qualifications

  • 10 years experience designing and developing software in an environment using a full software development lifecycle approach.
  • 5 years experience as technical team lead. Direct supervision experience is a plus.
  • Expertise in ASP.NET using C#, demonstrating object-oriented, multi-tier architecture and design
  • Expertise in HTML and CSS including thorough knowledge of cross-browser compatibility issues and SEO-friendly techniques.
  • Experience managing code releases and deploying production ready software systems
  • Experience in Waterfall and Agile development methodologies
  • Strong knowledge of SQL and experience developing data-driven web applications
  • Experience with mobile application development, HTML5, and jQuery preferred
  • Experience developing .NET Windows applications is a plus
  • Strong analytic and problem solving skills and passion for the web
  • Excellent communications and project management skills
  • College degree preferred
  • Ability to interact effectively with peers, business users and all levels of management
  • Ability to work with minimal supervision in a fast paced, dynamic environment
  • Knowledge of latest web technologies is required, as is a genuine interest in leveraging technology effectively for the good of the company

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Behavioral Health Customer Care Associate
open

Description

The Behavioral Health Associate (BHA) position is an entry level position for individuals with knowledge and experience of behavioral health treatment options, an awareness of the reimbursement process for behavioral health treatment, and skills in customer service. BHAs typically escalate complex or unstable callers to a Behavioral Health Specialist.

Essential Job Functions

  • Answers inbound calls from members and providers related to behavioral health issues
  • Assists with explaining benefits and eligibility issues related to behavioral health coverage, including but not limited to requirements for precertification, benefit limitations, levels of care, use of provider networks, etc.
  • Obtains relevant clinical information from member for use in resolving issue the call is about
  • Identifies calls that are unique, complicated, have a clinical component such as medication usage, ECT, etc., or that member is at risk and escalates them to the appropriate Behavioral Health Specialist
  • Assists in locating psychologists, psychiatrists, facilities, and other behavioral health providers
  • Performs research to identify community and other resources for the treatment of behavior health conditions
  • Refers member to Employee Assistance Programs and services as appropriate to the needs of the member
  • Appropriately able to explain basic types of treatment and relate treatment to appropriate provider type based on clinical needs
  • Concisely and accurately enters documentation into system
  • Able to respond calmly and obtain assistance and support for callers in crisis

Qualifications

  • Bachelor’s degree in Psychology, Social Work, Rehabilitation Counseling or related field
  • Minimum one year of experience in an area of behavioral health – required
  • Solid computer proficiency
  • Excellent verbal and written communication skills required for speaking to members, physicians’ offices, hospitals, insurance companies, healthcare facilities and for documenting notes in computer system for follow-up
  • Attention to detail required for tracking cases and following-up with members and providers on a timely basis
  • Must be organized and have ability to multi-task and handle multiple cases
  • Team player – willing to learn, assist and help other team members as required
  • Must have excellent customer service skills
  • Bilingual in Spanish/English a plus

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Benefits Associate FT
open

Description

Responsible for interfacing with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors and detailed benefit review; answer incoming calls and respond to benefit inquires; place outbound follow-up calls for issues that cannot be resolved during the initial call; provide guidance to members on open enrollment issues, questions and concerns about benefit options which may include comparing and contrasting benefits during open enrollment, new hires and change of status

Major Job Accountabilities

Benefits Functions – Interface with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors, and detailed benefit review ensuring adherence to department and corporate policies and procedures

  • Answer incoming calls/cases and respond to member benefit inquires, cases and calls assigned by supervisor and place outbound calls and/or contacts to members for calls and cases that cannot be resolved during the initial call
  • Provide objective information to members on open enrollment issues, questions and concerns about benefit options which may include comparing and contrasting benefits during open enrollment, new hires and change of status
  • Connect with members by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options
  • Answer members’ questions related to benefit plans (i.e., medical, dental, pharmacy, vision, life, STD, LTD, and other benefits) consumer driven health plans, FSAs, provider selection, qualifying life events, open enrollment, and estimated cost of care
  • Review plan options and costs for members considering individual health insurance plans, Marketplace/exchange plans, COBRA, and Medicare plans
  • Exercise exceptional customer service skills in an effort to optimize each contact with the member
  • Ensure that calls are processed in strict adherence to established policies, procedures, quality standards as well as applicable federal laws and regulations
  • Know and support approved departmental and corporate policies and procedures relating to benefit issues
  • Ensure policies and procedures are in compliance with all applicable laws and regulations, including the privacy of employee health information in compliance with federal and state laws such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Affordable Care Act, and other legislation

Benefit Research Assistance –Resolve benefit issues by identifying issue(s) and researching in a timely manner ensuring adherence to department and corporate policies and procedures

  • Follow research through until resolution
  • Document all benefit issues thoroughly maintaining department files and appropriate databases
  • Continuously evaluate the status of all work efforts, ensuring all tasks are prioritized to assist in providing timely and quality services
  • Assist in monitoring issue trends, escalating such trends to supervisor to determine appropriate actions necessary to eliminate future occurrences and improve service levels

Team Interfaces/Customer Service - Establish and maintain a professional relationship with internal/external customers, team members and department contacts

  • Cooperate with team members to meet goals or complete tasks
  • Provide quality customer service that exceeds customer expectations and improves level of service being provided
  • Treat all internal/external customers, team members and department contacts with dignity/respect
  • Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided

Mental and Physical Requirements

  • This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers
  • The nature of the work in this position is sedentary and the incumbent will be sitting most of the time.
  • Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
  • Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work day

Related Duties as Assigned

  • The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents
  • Consequently, job incumbents may be asked to perform other duties as required
  • Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above
  • Please contact your local Employee Relations representative to request a review of any such accommodations

Qualifications

Applicant for this job will be expected to meet the following minimum qualifications.

Education

  • High School Degree or GED required
  • Associate’s degree from an accredited college or university with major course work in business administration, liberal arts, public health, healthcare management, or a related field preferred.

Experience

  • Minimum of one year customer service, healthcare or employee benefits experience required.

Other

  • Basic knowledge of MS Word and Excel required
  • Must score acceptably on job related testing
  • Ability to pass standardized interview
  • Based on assignment may need to be bilingual in English, Spanish, etc.
  • Knowledge of the following is preferred:
    • COBRA
    • Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans
    • High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs)
    • Flex Spending Accounts (FSA) , including limited FSAs
    • Coordination of benefits and which plan is primary – simple cases (commercial plans, Medicare plans)
    • Summary Plan Documents (SPDs) and Certificates of Coverage (COCs)
    • Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP
    • Group Health Plans (fully insured and self-insured)
    • Pharmacy benefits including injectable medications
    • Individual Health Plans and Marketplace/Exchanges plans
  • A successful incumbent in the job will be able to demonstrate the following skills and abilities:
    • Strong communication skills and phone etiquette
    • Ability to explain complex issues to members
    • Highly effective listening skills
    • Strong problems solving/issue resolution skills
    • Excellent customer service and customer resolution skills
    • Strong Organizational and administrative skills
    • Ability to work in a team environment

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Benefits Associate PT
open

Description

Responsible for interfacing with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors and detailed benefit review; answer incoming calls and respond to benefit inquires; place outbound follow-up calls for issues that cannot be resolved during the initial call; provide guidance to members on open enrollment issues, questions and concerns about benefit options which may include comparing and contrasting benefits during open enrollment, new hires and change of status

Major Job Accountabilities

Benefits Functions – Interface with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors, and detailed benefit review ensuring adherence to department and corporate policies and procedures

  • Answer incoming calls/cases and respond to member benefit inquires, cases and calls assigned by supervisor and place outbound calls and/or contacts to members for calls and cases that cannot be resolved during the initial call
  • Provide objective information to members on open enrollment issues, questions and concerns about benefit options which may include comparing and contrasting benefits during open enrollment, new hires and change of status
  • Connect with members by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options
  • Answer members’ questions related to benefit plans (i.e., medical, dental, pharmacy, vision, life, STD, LTD, and other benefits) consumer driven health plans, FSAs, provider selection, qualifying life events, open enrollment, and estimated cost of care
  • Review plan options and costs for members considering individual health insurance plans, Marketplace/exchange plans, COBRA, and Medicare plans
  • Exercise exceptional customer service skills in an effort to optimize each contact with the member
  • Ensure that calls are processed in strict adherence to established policies, procedures, quality standards as well as applicable federal laws and regulations
  • Know and support approved departmental and corporate policies and procedures relating to benefit issues
  • Ensure policies and procedures are in compliance with all applicable laws and regulations, including the privacy of employee health information in compliance with federal and state laws such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Affordable Care Act, and other legislation

Benefit Research Assistance –Resolve benefit issues by identifying issue(s) and researching in a timely manner ensuring adherence to department and corporate policies and procedures

  • Follow research through until resolution
  • Document all benefit issues thoroughly maintaining department files and appropriate databases
  • Continuously evaluate the status of all work efforts, ensuring all tasks are prioritized to assist in providing timely and quality services
  • Assist in monitoring issue trends, escalating such trends to supervisor to determine appropriate actions necessary to eliminate future occurrences and improve service levels

Team Interfaces/Customer Service - Establish and maintain a professional relationship with internal/external customers, team members and department contacts

  • Cooperate with team members to meet goals or complete tasks
  • Provide quality customer service that exceeds customer expectations and improves level of service being provided
  • Treat all internal/external customers, team members and department contacts with dignity/respect
  • Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided

Mental and Physical Requirements

  • This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers
  • The nature of the work in this position is sedentary and the incumbent will be sitting most of the time.
  • Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
  • Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work day

Related Duties as Assigned

  • The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents
  • Consequently, job incumbents may be asked to perform other duties as required
  • Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above
  • Please contact your local Employee Relations representative to request a review of any such accommodations

Qualifications

Applicant for this job will be expected to meet the following minimum qualifications.

Education

  • High School Degree or GED required
  • Associate’s degree from an accredited college or university with major course work in business administration, liberal arts, public health, healthcare management, or a related field preferred.

Experience

  • Minimum of one year customer service, healthcare or employee benefits experience required.

Other

  • Basic knowledge of MS Word and Excel required
  • Must score acceptably on job related testing
  • Ability to pass standardized interview
  • Based on assignment may need to be bilingual in English, Spanish, etc.
  • Knowledge of the following is preferred:
    • COBRA
    • Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans
    • High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs)
    • Flex Spending Accounts (FSA) , including limited FSAs
    • Coordination of benefits and which plan is primary – simple cases (commercial plans, Medicare plans)
    • Summary Plan Documents (SPDs) and Certificates of Coverage (COCs)
    • Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP
    • Group Health Plans (fully insured and self-insured)
    • Pharmacy benefits including injectable medications
    • Individual Health Plans and Marketplace/Exchanges plans
  • A successful incumbent in the job will be able to demonstrate the following skills and abilities:
    • Strong communication skills and phone etiquette
    • Ability to explain complex issues to members
    • Highly effective listening skills
    • Strong problems solving/issue resolution skills
    • Excellent customer service and customer resolution skills
    • Strong Organizational and administrative skills
    • Ability to work in a team environment

Applications will be accepted through 09/17/15.

EEO/AAP Employer-Minorities/Women/Disabled/Protected Veterans

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Benefits Specialist
open

At Health Advocate, we are committed to providing our customers with services that improve the health, well-being and productivity of their employees.  We are looking for the right people with experience who can respond to benefits inquiries and assist members with plan selection decisions. Our Benefit Specialists telephonically provide high quality support to the employees of our clients. Members receive help in understanding their benefit plan offering, and direction in working through a variety of benefit issues. The Benefit Specialist will be required to interface with many internal and external resources to provide guidance and direction regarding plan options, cost factors and detailed benefit review.

Job Responsibilities:

  • Professionally answers incoming calls and respond to member inquiries.
  • Provide guidance to members on open enrollment issues, questions and concerns about benefit options.
  • Connect with customers by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options
  • Educate customers on health benefits options and programs offered by their employer
  • Answer customer questions related to Benefit Plans (i.e. medical, dental, life, STD, LTD), consumer-driven health plans, FSAs, provider selection, qualifying life events and the open enrollment process
  • Place outbound follow up calls for issues that can not be resolved during the initial call

Preferred Qualifications:

  • Bachelor's Degree or other applicable work experience.
  • 3 years prior benefits experience preferred
  • Strong communication skills and phone etiquette
  • Strong ability to explain complex issues to employees/retirees
  • Highly effectively listening skills
  • Strong problem solving/issue resolution skills
  • Excellent customer service and customer resolution skills
  • Experience with Microsoft Word and Excel
  • Ability to work in a team environment.

Certificates/licenses:

  • CEBS, PHR, SPHR or CBP certification a plus.
  • Completed health/life licensing coursework and/or attainment of license and completion of continuing education coursework a plus.

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Business Intelligence Analyst
open

Description

Job Scope
Health Advocate is seeking a highly qualified, hands-on candidate for the position of Business Intelligence Analyst. The selected, hands-on individual will provide advice and instruction on technical matters to database analysts and application developers. The position will require proficiency in many areas of SQL Server including Reporting Services, programming, advanced query-writing, ETL, reporting. Success in this position will require effective interpersonal skills as the position will require the individual to frequently interact with teammates, managers and personnel in user departments.

Responsibilities

  • Develop new reports in accordance with requirements gathered from business users
  • Maintain and support existing reports through modifications, troubleshooting, and performance enhancements
  • Work alongside team in developing and implementing the data warehouse, this includes cubes, data marts, and advance queries and ETL packages

Qualifications

  • Three (3) or more years of SQL Server database architecture and design experience
  • Expertise in programming using SQL and related technologies including performance tuning and troubleshooting, such as Reporting Services
  • Strong knowledge of T-SQL, SQL Reporting Services, Analysis Services, SSIS and other reporting, database, and data warehousing technologies
  • Strong analytic and problem-solving skills
  • Excellent oral and written communication and project management skills
  • Bachelor’s degree, or equivalent work experience
  • Ability to interact effectively with peers, business users and all levels of management
  • Ability to work with minimal supervision in a fast-paced, dynamic environment

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Claims Specialist
open

Our Claims Specialists are compassionate, dedicated individuals with first-rate listening and problem-solving skills who enjoy the challenge of resolving complex billing and claims issues. When a member contacts Health Advocate about a claims issue, the member establishes a relationship with one of our claims specialists who works with the member through to the resolution of their problem.

Job Description- As a Claims Specialist, you will:

  • Research and solve claims and billing issues
  • Interface with insurance carriers, physicians, hospitals and other healthcare providers
  • Help members with eligibility and benefits coverage questions
  • Assist in negotiating fees with healthcare providers on behalf of members

Qualifications

  • Must have 3 years medical and/or dental billing/claims experience
  • Must have experience working with health plan documents, benefit plans
  • Must have excellent customer service skills
  • Experience with fee negotiation desirable
  • Ability to follow-up with health plans, providers and members to resolve questions and problems
  • Knowledge of CPT, ICD-9 and HCPCS coding
  • Top-notch verbal and written communication skills
  • Proficiency with various software applications (Outlook, Excel, Word) and computer systems
  • Familiarity with the web/Internet
  • Ability to work flexible weekdays, including some evenings until 9 PM
  • Bilingual in Spanish/English a plus

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Client Operations Supervisor
open

Description

Our Client Operations Supervisor will be responsible for the supervision and administration of the client operations team & responsible for client implementation activities and supporting internal operations areas. This includes the installation of new cases, processing benefit changes, loading inbound eligibility data, distribution and collection of member surveys, development and delivery of internal reports, and the coordination of end user system testing.

Major Job Accountabilities

Client Operations Supervisor Functions – Supervision and administration of the client operations team & responsible for client implementation activities and supporting internal operations areas. This includes the installation of new cases, processing benefit changes, loading inbound eligibility data, distribution and collection of member surveys, development and delivery of internal reports, and the coordination of end user system testing.

  • Ensure assigned staff meets or exceeds the standards, results, and responsibilities of their respective positions.
  • Metric management; meet with staff to coach and counsel to meet/improve performance.
  • Assist in developing policies, procedures, and workflows to improve productivity and quality.
  • Act as liaison between the operational units to help ensure that they have the tools and resources to meet their goals.
  • Conduct process improvement projects with internal supervisors and the systems development team.
  • Serve as a contact for the internal personnel with questions about service delivery and/or data needs.
  • Participate on client calls as needed to ensure accurate information is provided to support the implementation process.
  • Accountable for tracking the resolution of issues, following up with other Health Advocate areas to ensure timely resolution.

Team Interfaces/Customer Service - Establish and maintain a professional relationship with internal/external customers, team members and department contacts

  • Cooperate with team members to meet goals or complete tasks
  • Provide quality customer service that exceeds customer expectations and improves level of service being provided
  • Treat all internal/external customers, team members and department contacts with dignity/respect
  • Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided

Mental and Physical Requirements

  • This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers
  • The nature of the work in this position is sedentary and the incumbent will be sitting most of the time.
  • Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
  • Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work day

Qualifications

Applicant for this job will be expected to meet the following minimum qualifications.

  • Proven skills on systems and projects/enhancements
  • Excellent organizational skills and time management skills
  • Knowledge of insurance products is preferred
  • Demonstrated ability to communicate technical concepts, strategies and plans in terminology understood by business and IT professionals
  • Excellent interpersonal skills - with an emphasis on ability to communicate both verbally and in writing
  • Ability to work in a team-based environment required
  • Ability to work directly with business partners, clients and vendors required
  • Proficient computer skills and experience in Microsoft Suite, Adobe PDF & Internet Searches

Education

  • High School Degree or GED required
  • Bachelor’s Degree or applicable work experience; incumbents typically have 3 years of related experience

Experience

  • Strong operations background. Prior work experience in a call center based environment preferred

Other

  • Must score acceptably on job related testing
  • Based on program may need to be bilingual in English, Spanish, etc.

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Client Services Manager
open

Description

A Client Service Manager is needed with proven operations and client facing skills with strong communication and organizational skills in order to successfully implement and maintain a strong client relationship.

Major Job Accountabilities

Client Service Manager Functions – proven operations and client facing skills with strong communication and organizational skills in order to successfully implement and maintain a strong client relationship.

  • Serve as the primary contact for the sales team and customers to install clients in a timely manner
  • Produce and distribute implementation plan to ensure timely delivery of installation services
  • Serve as a contact for new clients as assigned with questions about installation and ongoing needs. This includes but is not limited to working with client’s eligibility vendor to create, receive and test eligibility file; obtain client benefit documents; establish client’s ongoing reporting needs; and educating key contacts on the services
  • Accountable for the timely and high quality production of the customer requirements. Performs critical information gathering and interpretation to ensure client specifications regarding products, structure, billing and eligibility
  • Responsible for ongoing client needs after implementation
  • Accountable for tracking the resolution of client issues, following up with other Health Advocate areas to ensure timely resolution
  • Provide support to assigned accounts by responding to inquires or resolving issues of concern
  • Serve as a liaison between the operational units and the sales team to ensure a smooth and complete installation of a client’s account and to maintain relationship with client
  • Identify opportunities for up-sales
  • Obtain client specific contractual information and develop it as an accessible reference for operational staff
  • Act as subject matter expert for internal parties in reference to assigned clients
  • Deliver reports to client in a timely manner

Team Interfaces/Customer Service - Establish and maintain a professional relationship with internal/external customers, team members and department contacts

  • Cooperate with team members to meet goals or complete tasks
  • Provide quality customer service that exceeds customer expectations and improves level of service being provided
  • Treat all internal/external customers, team members and department contacts with dignity/respect
  • Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided

Mental and Physical Requirements

  • This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers
  • The nature of the work in this position is sedentary and the incumbent will be sitting most of the time.
  • Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
  • Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work day

Related Duties as Assigned

  • The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents
  • Consequently, job incumbents may be asked to perform other duties as required
  • Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above
  • Please contact your local Employee Relations representative to request a review of any such accommodations

Qualifications

  • Applicant for this job will be expected to meet the following minimum qualifications.
  • Ability to perform tasks independent of direct supervision with good follow up
  • Excellent organizational skills and time management skills
  • Direct contact with corporate clients in a service or project management capacity
  • Demonstrated ability to communicate effectively with key contacts such as clients, vendor partners, and internal partners to support client’s needs.
  • Excellent interpersonal skills – with an emphasis on ability to communicate both verbally and in writing
  • Ability to work in a team-based environment required
  • Ability to work with direct business partners, clients and vendors required
  • Some travel required

Education

  • High School Degree or GED required
  • Bachelor’s Degree or applicable work experience; incumbents typically have 3 years of related experience

Experience

  • Strong operations background. Prior work experience in a call center based environment preferred
  • Prior knowledge of outlining reporting requirements and understanding of concepts of system requirements from and operations perspective preferred
  • Proficient computer skills and experience in Microsoft Suite, Adobe PDF & Internet Searches required
  • Knowledge of insurance products is required

Other

  • Must score acceptably on job related testing
  • Based on program may need to be bilingual in English, Spanish, etc.

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Customer Care Associate
open

Our Customer Care Associates are compassionate and dedicated professionals with exceptional listening skills who assist our members in navigating the healthcare system. They work as part of a team and demonstrate customer service excellence.

Essential Job Functions

  • Receives member?s pre-service requests on the toll free 800#, determines needs, gets demographic information and directs to proper area of responsibility, if it is symptom related or post-service request.
  • If the caller is requesting routine locator information, the Customer Care Associate can help them directly (e.g. eldercare assistance, health and Rx plan schedules, identifying resources for employer health plans).
  • Achieve or exceed Call Center Metrics.
  • Assist members and their families with basic healthcare questions and helps them to understand and utilize their health insurance benefits coverage. This request can come from the member or from another member of the Health Advocate staff
  • Handle routine to moderate issues with regular supervision such as answering member questions, dealing with irate members and assisting other departments with their member cases.
  • Regular contact with members, physician office receptionist and insurance carrier customer service representatives.

Requirements

  • Achieve/exceed call center metrics (ASA=<30 seconds; Abandon Rate = <5%)
  • Identify target resolution for all member calls and then, if possible, ensure cases close at or near the target resolution
  • Inform members of your plan of action, expected results and timeframes, then meet or exceed those timeframes
  • Build confidence in our services to encourage members to call back with future questions.
  • Allay member anxiety and frustration
  • Add value to our services by going beyond the member?s initial request
  • Locate providers for routine care (non-symptom based) using HA?s policy and procedure
  • Assist PHA?s in the location of healthcare providers
  • Research of employer group plan documentation, and the communication with insurance carrier representatives
  • Clarify insurance plan provisions to members
  • Link members to the appropriate health care services and providers; locate participating providers
  • Assist seniors and their families in finding senior housing and care facilities, health and prescription plans
  • Document all cases in case management system using the SOAP method (Subjective, Objective, Assessment, Plan) when appropriate
  • Research, locate services as requested by members including gym and exercise classes, smoking cessation programs
  • Intercedes for the member to obtain earlier appointments

Other Skills/Abilities

  • College degree or one to three years customer service experience, preferably in healthcare
  • Understanding of basic medical terminology to assist in locating appropriate care options
  • Telephone triage experience helpful
  • Understanding of health benefit plans and the insurance industry
  • Understanding of medical procedures, including billing, diagnosis codes and pre-certification
  • Understanding of Home Care Services
  • Strong desire to provide outstanding customer service
  • Ability to work as part of a team
  • Ability to educate callers
  • Strong listening skills and empathy
  • Ability to ask open-ended questions and uncover information
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives
  • Ability to calm anxious callers and defusing angry or hostile callers
  • Assertive, self-confident and resilient
  • Attention to detail and strong documentation skills
  • Demonstrate appropriate judgment in escalating cases in a timely manner to supervisors
  • Ability to think outside the box
  • Well organized, meticulous attention to detail with ability to multi-task
  • Proficient computer skills (Microsoft Office, Excel, Outlook, Adobe PDF, Internet Searches)

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Customer Care Associate - Full-time, Evening
open

Essential Job Functions

  • Receives member’s pre-service requests on the toll free 800#, determines needs, gets demographic information and directs to proper area of responsibility, if it is symptom related or post-service request.
  • If the caller is requesting routine locator information, the Customer Care Associate can help them directly (e.g. eldercare assistance, health and Rx plan schedules, identifying resources for employer health plans).
  • Achieve or exceed Call Center Metrics.
  • Assist members and their families with basic healthcare questions and helps them to understand and utilize their health insurance benefits coverage. This request can come from the member or from another member of the Health Advocate staff
  • Handle routine to moderate issues with regular supervision such as answering member questions, dealing with irate members and assisting other departments with their member cases.
  • Regular contact with members, physician office receptionist and insurance carrier customer service representatives.

Requirements

  • Achieve/exceed call center metrics (ASA=<30 seconds; Abandon Rate = <5%)
  • Identify target resolution for all member calls and then, if possible, ensure cases close at or near the target resolution
  • Inform members of your plan of action, expected results and timeframes, then meet or exceed those timeframes
  • Build confidence in our services to encourage members to call back with future questions.
  • Allay member anxiety and frustration
  • Add value to our services by going beyond the member’s initial request
  • Locate providers for routine care (non-symptom based) using HA’s policy and procedure
  • Assist PHA’s in the location of healthcare providers
  • Research of employer group plan documentation, and the communication with insurance carrier representatives
  • Clarify insurance plan provisions to members
  • Link members to the appropriate health care services and providers; locate participating providers
  • Assist seniors and their families in finding senior housing and care facilities, health and prescription plans
  • Document all cases in case management system using the SOAP method (Subjective, Objective, Assessment, Plan) when appropriate
  • Research, locate services as requested by members including gym and exercise classes, smoking cessation programs
  • Intercedes for the member to obtain earlier appointments

Other Skills/Abilities

  • College degree or one to three years customer service experience, preferably in healthcare
  • Understanding of basic medical terminology to assist in locating appropriate care options
  • Telephone triage experience helpful
  • Understanding of health benefit plans and the insurance industry
  • Understanding of medical procedures, including billing, diagnosis codes and pre-certification
  • Understanding of Home Care Services
  • Strong desire to provide outstanding customer service
  • Ability to work as part of a team
  • Ability to educate callers
  • Strong listening skills and empathy
  • Ability to ask open-ended questions and uncover information
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives
  • Ability to calm anxious callers and defusing angry or hostile callers
  • Assertive, self-confident and resilient
  • Attention to detail and strong documentation skills
  • Demonstrate appropriate judgment in escalating cases in a timely manner to supervisors
  • Ability to think outside the box
  • Well organized, meticulous attention to detail with ability to multi-task
  • Proficient computer skills (Microsoft Office, Excel, Outlook, Adobe PDF, Internet Searches)

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Customer Care Associate - Part-time, Evening
open

Essential Job Functions

  • Receives member’s pre-service requests on the toll free 800#, determines needs, gets demographic information and directs to proper area of responsibility, if it is symptom related or post-service request.
  • If the caller is requesting routine locator information, the Customer Care Associate can help them directly (e.g. eldercare assistance, health and Rx plan schedules, identifying resources for employer health plans).
  • Achieve or exceed Call Center Metrics.
  • Assist members and their families with basic healthcare questions and helps them to understand and utilize their health insurance benefits coverage. This request can come from the member or from another member of the Health Advocate staff
  • Handle routine to moderate issues with regular supervision such as answering member questions, dealing with irate members and assisting other departments with their member cases.
  • Regular contact with members, physician office receptionist and insurance carrier customer service representatives.

Requirements

  • Achieve/exceed call center metrics (ASA=<30 seconds; Abandon Rate = <5%)
  • Identify target resolution for all member calls and then, if possible, ensure cases close at or near the target resolution
  • Inform members of your plan of action, expected results and timeframes, then meet or exceed those timeframes
  • Build confidence in our services to encourage members to call back with future questions.
  • Allay member anxiety and frustration
  • Add value to our services by going beyond the member’s initial request
  • Locate providers for routine care (non-symptom based) using HA’s policy and procedure
  • Assist PHA’s in the location of healthcare providers
  • Research of employer group plan documentation, and the communication with insurance carrier representatives
  • Clarify insurance plan provisions to members
  • Link members to the appropriate health care services and providers; locate participating providers
  • Assist seniors and their families in finding senior housing and care facilities, health and prescription plans
  • Document all cases in case management system using the SOAP method (Subjective, Objective, Assessment, Plan) when appropriate
  • Research, locate services as requested by members including gym and exercise classes, smoking cessation programs
  • Intercedes for the member to obtain earlier appointments

Other Skills/Abilities

  • College degree or one to three years customer service experience, preferably in healthcare
  • Understanding of basic medical terminology to assist in locating appropriate care options
  • Telephone triage experience helpful
  • Understanding of health benefit plans and the insurance industry
  • Understanding of medical procedures, including billing, diagnosis codes and pre-certification
  • Understanding of Home Care Services
  • Strong desire to provide outstanding customer service
  • Ability to work as part of a team
  • Ability to educate callers
  • Strong listening skills and empathy
  • Ability to ask open-ended questions and uncover information
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives
  • Ability to calm anxious callers and defusing angry or hostile callers
  • Assertive, self-confident and resilient
  • Attention to detail and strong documentation skills
  • Demonstrate appropriate judgment in escalating cases in a timely manner to supervisors
  • Ability to think outside the box
  • Well organized, meticulous attention to detail with ability to multi-task
  • Proficient computer skills (Microsoft Office, Excel, Outlook, Adobe PDF, Internet Searches)

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
E2H Associate Consultant
open

Description

Engage2Health (e2H) is the analytics and informatics division of Health Advocate, Inc., a subsidiary of West Corporation. Health Advocate is the nation’s leading health care advocacy and assistance company, serving more than 9,000 clients and nearly 24 million people across the country. The company offers a range of personalized services to help employees and their families navigate the complex health and insurance systems. The ultimate goal is to help improve employee health care outcomes while simultaneously reducing medical expenditures.

In order to serve the needs of a diverse clientele, engage2Health specializes in health services and outcomes research and population management interventions. The e2H team integrates complex sources of health care data to provide customized solutions that promote quality and value in health care. The company is committed to the academic integrity of its programs and maintains a portfolio of peer-reviewed studies that adhere to rigorous scientific standards.

About the Position

Under minimal supervision, the Associate Consultant will be responsible for performing qualitative and quantitative analysis on a wide array of issues across disciplines, projects, and functional areas. Primary duties include managing the scope and operational aspects clients’ projects, creating project deliverables, synthesizing analytical data, writing reports, validating datasets, performing clinical research, and leading product development.

Potential Responsibilities

  • Analyze employer health care data to identify key insights and translate them into actionable feedback
  • Brainstorm, construct, test, and modify a collection of business intelligence tools, including dynamic, web-based dashboards
  • Develop and produce health-related communications, including presentations, reports, and manuscripts for distribution to senior-level management officials and/or clients
  • Implement retrospective analyses through the design, collection, and statistical analysis of databases
  • Perform literature reviews and undertake secondary research initiatives, including the retrieval and analysis of data, competitive product pipeline information, etc.
  • Assist with the design, execution, analysis, and reporting of primary research and/or projects for global pharmaceutical/biotechnology clients

Qualifications

  • Demonstrated problem solving, analytical reasoning, and decision-making skills (required)
  • Strong multi-tasking and organizational abilities (required)
  • Dedicated willingness to meet crucial goals, objectives, and deadlines (required)
  • Excellent interpersonal, verbal, and written communication skills (required)
  • Reliable leadership abilities, accountability, and initiative (required)
  • Advanced level of Excel-based analytics (preferred)
  • Proficiency in SAS and/or STATA (preferred)

Qualifications, Education and Experience

  • Bachelor’s degree (required), with focus on economics, statistics, engineering, public health, public policy, health sciences, natural sciences, or business (preferred)
  • Strong knowledge of and/or interest in one or more of the following areas: biostatistics, big data, epidemiology, analytic research methods and modeling, healthcare (required)
  • Up to three years of professional experience, preferably in consulting or the healthcare industry, including life sciences, healthcare providers, and managed care organizations (preferred)
  • Master’s degree in a scientific discipline, public health, business administration, or another relevant area (preferred)

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
EAP Care Manager
open

Description

  • Receive and respond to intake calls
  • Explains role of EAP and confidentiality
  • Obtains and records intake case information in Care Management System
  • Assess crisis situation and take appropriate action
  • Provides referral services to EAP clients
  • Provides information and schedules clients requesting phone services
  • Provides members with appropriate referral based on clinical needs, provider expertise, location, insurance coverage and affordability
  • Facilitates referral process and contacts service providers or subcontracted EAP affiliates
  • Follow up with client and/or service provider /affiliate as required per Standard Operating Procedure
  • Documents all contacts with clients and pertinent others accurately, completely and concisely
  • Facilitates connection or referral to other available services such as legal/financial consultation, work-life resources, or other solutions that may be available to Health Advocate members
  • Provide other Employee Assistance services as assigned including case management of special needs, high risk and company –initiated referrals
  • Provide telephonic services including assessment, crisis-intervention, consultation with Human Resources or other client company leadership, and brief support to members
  • Collaborates with Care Managers and others to ensure compliance with SOP, to provide excellent member service and experience, and to support professional operations and environment within the EA division
  • Participate in regular supervision and consultation as needed/appropriate to any case
  • Develop and maintain familiarity with Health Advocate EAP Standard Operating Procedures as demonstrated by the delivery of service and performance of duties
  • Maintain reliable attendance and timely arrival being ready to work as scheduled
  • Maintain licenses in good standing, and related credentials if applicable
  • Miscellaneous duties as assigned by Director or Executive management

Qualifications

  • Master’s degree in behavioral health discipline required (social work, counseling, or related human service field)
  • Minimum three years graduate level experience, providing direct service in behavioral health setting including assessment and case management
  • A combination of graduate and bachelor’s level experience including behavioral healthcare utilization-review, Employee Assistance or similar call center work, or direct service in a community treatment or recovery center will be considered
  • Desirable, not required: CEAP, CADC, NBCC

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Key Account Specialist
open

Description

A Key Account Specialist is needed with proven operations and client facing skills with strong communication and organizational skills in order to successfully implement and maintain a strong client relationship.

Essential Job Functions

  • Serve as the primary contact for the sales team and customers to install clients of medium complexity in a timely manner
  • Produce and distribute implementation plan to ensure timely delivery of installation services
  • Serve as a contact for new clients as assigned with questions about installation and ongoing needs. This includes but is not limited to working with client’s eligibility vendor to create, receive and test eligibility file; obtain client benefit documents; establish client’s ongoing reporting needs; and educating key contacts on the services. Involve other subject matter experts to assist as necessary.
  • Accountable for the timely and high quality production of the customer requirements. Performs critical information gathering and interpretation to ensure client specifications regarding products, structure, billing and eligibility
  • Responsible for ongoing client needs after implementation. Escalate non-standard requests to supervisor for assistance.
  • Accountable for tracking the resolution of client issues, following up with other Health Advocate areas to ensure timely resolution
  • Provide support to assigned accounts by responding to inquires or resolving issues of concern
  • With limited assistance from supervisor, serve as a liaison between the operational units and the sales team to ensure a smooth and complete installation of a client’s account and to maintain relationship with client
  • Identify opportunities for up-sales
  • Obtain client specific contractual information and develop it as an accessible reference for operational staff
  • Act as subject matter expert for internal parties in reference to assigned clients
  • Deliver reports to client in a timely manner

Qualifications

  • Bachelor’s Degree or applicable work experience; incumbents typically have more than 2 years of related experience
  • Proven skills in Microsoft Office products including Outlook, Excel, Word and PowerPoint required
  • Prior knowledge of outlining reporting requirements and understanding of concepts of system requirements from an operations perspective preferred
  • Ability to perform tasks with limited direct supervision with good follow up
  • Proven organizational skills and time management skills
  • Knowledge of insurance products is required
  • Direct contact with corporate clients in a service or project management capacity
  • Strong operations background preferred
  • Prior work experience in a call center based environment preferred
  • Demonstrated ability to communicate effectively with key contacts such as clients, vendor partners, and internal partners to support client’s needs.
  • Excellent interpersonal skills – with an emphasis on ability to communicate both verbally and in writing
  • Ability to work in a team-based environment required
  • Ability to work with direct business partners, clients and vendors required
  • Some travel required

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Medical Cost Negotiator and Claims Specialist
open

Description

Position Overview

At Health Advocate, we are committed to providing our customers with expertise and services that improve the health, well-being and productivity of their employees. We are looking for the right person to: work with medical providers to negotiate balances outstanding on members claims.

The appropriate candidate would be responsible for managing multiple claims cases, interfacing with internal staff and external providers to understand and negotiate claims balances. The appropriate candidate will follow up to ensure all aspects of the negotiation are documented and processed for member satisfaction.

Essential Job Functions

  • Handles Member calls & cases for claims fee negotiation
  • Negotiates Consumer/Member Medical Claims with Healthcare Providers
  • Send and Acknowledge receipt of Contracts from Consumers/Members and ProvidersTracks all Settlements
  • Reports Settlement results within the system and Statistics to Management
  • Works with other Health Advocate units, including training when requested
  • Works with product development VP to refine process and improve the Consumer/Member Settlement product
  • Supports Sales & Marketing as SME, including participation in meetings with Current and Prospective Customers
  • Provide benefit and claims consultation and support when appropriate to all internal departments

Qualifications

  • Claims or Call center experience preferred
  • Bachelor's Degree or applicable work experience
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing
  • Assertive, self-confident, and resilient
  • Basic computer skills
  • Ability to search and identify resources through the internet
  • Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals
  • Ability to interpret Explanation of Benefits (EOBs)
  • Familiarity with various types of health insurance coverage, coordination of benefits, and UCR fees
  • Must be able to work from a paperless file

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Operations Supervisor
open

Description

At Health Advocate, we are committed to providing our customers with expertise and services that improve the health, well-being and productivity of their employees. We are looking for the right person to: Manage an operational unit that enables us to best serve our clients and employees answering questions and responding to inquiries regarding employee benefit plans.

The appropriate candidate would be responsible for managing workflow with a phone unit , developing and implementing policies and procedures, training staff to perform specific functions and managing employee performance.

The right candidate will lead recruiting, hiring and training efforts that enable creative solutions to identifying the best candidates and enabling the new hires for success.

Job Responsibilities

  • Responsible for the administrative functions and supervision of an operations unit. This includes backlog and quality management for a team of Operations/Customer Service associates
  • Provide organization, direction and staffing for all assigned service calls and case load assignments to ensure all calls are answered in accordance with Health Advocate’s policies and procedures.
  • Monitor calls and audit case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed at or near the target resolution.
  • Ensure assigned staff members meet or exceed the standards, results, and responsibilities of their respective positions.
  • Coach, mentor, and evaluate the performance of an assigned team.
  • Assist in the selection, counseling, and discipline of all staff on the team.
  • Provide oversight and direction to staff for assigned cases.
  • Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts.
  • Provide healthcare benefit and claims consultation and support when appropriate to all internal departments.
  • Routinely evaluate and monitor service calls and case management procedures to recommend any necessary changes to the Operations Manager.
  • Escalate cases through the appropriate channels in accordance with Health Advocate’s policies and procedures.

Qualifications

  • Call center experience preferred
  • Bachelor's Degree or applicable work experience.
  • Management or supervisory experience in healthcare benefits or claims processing.
  • Strong leadership skills and the ability to build effective teams.
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing.
  • Assertive, self-confident, and resilient.
  • Basic computer skills.
  • Ability to search and identify resources through the internet.
  • Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals.
  • Ability to interpret Explanation of Benefits (EOBs).
  • Familiarity with various types of health insurance coverage, coordination of benefits, and UCR fees.

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Operations Supervisor - Evening
open

Description

At Health Advocate, we are committed to providing our customers with expertise and services that improve the health, well-being and productivity of their employees. We are looking for the right person to: Manage an operational unit that enables us to best serve our clients and employees answering questions and responding to inquiries regarding employee benefit plans.

The appropriate candidate would be responsible for managing workflow with a phone unit , developing and implementing policies and procedures, training staff to perform specific functions and managing employee performance.

The right candidate will lead recruiting, hiring and training efforts that enable creative solutions to identifying the best candidates and enabling the new hires for success.

Job Responsibilities

  • Responsible for the administrative functions and supervision of an operations unit. This includes backlog and quality management for a team of Operations/Customer Service associates
  • Provide organization, direction and staffing for all assigned service calls and case load assignments to ensure all calls are answered in accordance with Health Advocate’s policies and procedures
  • Monitor calls and audit case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed at or near the target resolution
  • Ensure assigned staff members meet or exceed the standards, results, and responsibilities of their respective positions
  • Coach, mentor, and evaluate the performance of an assigned team
  • Assist in the selection, counseling, and discipline of all staff on the team
  • Provide oversight and direction to staff for assigned cases
  • Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts
  • Provide healthcare benefit and claims consultation and support when appropriate to all internal departments
  • Routinely evaluate and monitor service calls and case management procedures to recommend any necessary changes to the Operations Manager
  • Escalate cases through the appropriate channels in accordance with Health Advocate’s policies and procedures.

Qualifications

  • Call center experience preferred
  • Bachelor's Degree or applicable work experience.
  • Management or supervisory experience in healthcare benefits or claims processing.
  • Strong leadership skills and the ability to build effective teams.
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing.
  • Assertive, self-confident, and resilient.
  • Basic computer skills.
  • Ability to search and identify resources through the internet.
  • Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals.
  • Ability to interpret Explanation of Benefits (EOBs).
  • Familiarity with various types of health insurance coverage, coordination of benefits, and UCR fees.
  • A 10% shift differential is available for this position.

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
R.N. - Personal Health Advocate
open

Description

Position Overview

At Health Advocate, we are committed to providing our customers with services that improve the health, well-being and productivity of their employees. The Personal Health Advocates are a dedicated team of Registered Nurses who assist our members in navigating the healthcare system by facilitating access to healthcare providers, health and benefit information, health services and resources and entitled benefits coverage.

Essential Job Functions

  • Professionally answers incoming calls and respond to client inquiries
  • Connect with customers by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options.
  • Educate members regarding healthcare issues and options.
  • Provide members choices in medical care providers and services based on the members’ clinical needs, geographic locations and available benefit offerings.
  • Research providers through credentialing, education checks and affiliations with notable medical centers.
  • Facilitate communication among members, treating physicians and insurance carriers.
  • Help members understand their medical condition, reasons why a certain test is being performed and what to expect from the results.
  • Help members ask the right questions of their doctor.
  • Intercede for the member to obtain an earlier appointment.
  • Ensure member receives proper follow-up care after inpatient discharge
  • Help members obtain prescriptions
  • Help members with pre-service fee negotiations
  • Place outbound follow up calls for issues that cannot be resolved during the initial call
  • Respond to member cases in delegate box, answers and after hours calls
  • Mentor new team members
  • Work in-house and permanent

Qualifications

Other Skills/Abilities

  • Minimum three to five years clinical and/or medical management experience
  • Active and unrestricted State or Multi-State RN License
  • Understanding of medical terminology to assist in locating appropriate care options
  • Strong Communication skills and phone etiquette
  • Strong ability to explain complex issues to employees/retirees
  • Highly effective listening skills
  • Strong problem solving/issues resolution skills
  • Excellent customer service and customer resolution skills
  • Organizational and administrative skills
  • Experience with Microsoft Word and Excel
  • Ability to work in a team environment

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Research Associate
open

Description

Our Research Associates are dedicated professionals with exceptional computer skills to research and understand websites and reference materials regarding the healthcare system. They work as part of a team and demonstrate customer service excellence.

Essential Job Functions

  • Make outbound phone calls to medical providers, facilities and insurance companies in order to locate in-network providers
  • Navigate insurance websites to locate medical providers (primary care physicians and dentists)
  • Research benefit plans for complex benefit offerings
  • Identify resources and options to assist members
  • Concisely and accurately enter documentation into system
  • Compile research results into a user friendly format for members to review and respond

Qualifications

  • Strong comfort level in meeting call metrics
  • Excellent computer skills –must understand web navigation and Microsoft applications (word, excel, etc.)
  • Excellent verbal and written communication skills required for speaking to physicians' offices, hospitals, insurance companies and healthcare facilities
  • Attention to detail required for tracking cases
  • Must be organized and have ability to multi-task
  • Team player - willing to learn, assist and help other team members as required
  • Must have excellent customer services skills
  • Previous healthcare experience a plus

Applications will be accepted through 07/09/2015.

EEO/AAP Employer-Minorities/Women/Disabled/Protected Veterans

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
SAS Programmer Analyst
open

Description

Engage2Health (e2H) is the analytics and informatics division of Health Advocate, Inc., a subsidiary of West Corporation. Health Advocate is the nation’s leading health care advocacy and assistance company, serving more than 9,000 clients and nearly 24 million people across the country. The company offers a range of personalized services to help employees and their families navigate the complex health and insurance systems. The ultimate goal is to help improve employee health care outcomes while simultaneously reducing medical expenditures.

In order to serve the needs of a diverse clientele, engage2Health specializes in health services and outcomes research and population management interventions. The e2H team integrates complex sources of health care data to provide customized solutions that promote quality and value in health care. The company is committed to the academic integrity of its programs and maintains a portfolio of peer-reviewed studies that adhere to rigorous scientific standards.

About the Position

Health Care Analyst must have strong SAS programming knowledge and experience. Work with administrative claims data and other healthcare related data, and to provide data and analysis to support the organization in making data-driven decisions.

Potential Responsibilities

  • Collects, compiles and analyzes data to measure and report on provider and program performance
  • Designs and develops reports by understanding clients’ needs and ensures report data accuracy
  • Conducts analyses on trends of health care costs and utilizations and identifies underlying drivers for trends
  • Collaborates with other teams on improving the overall data infrastructure and process
  • Produces and maintains standard periodic reports, and performs ad-hoc analyses and reports to meet clients’ needs
  • Identifies, develops and implements methods for improving reporting efficiency
  • Performs checks and audits of various data sources to ensure data is accurate and complete
  • Maintains and applies knowledge of current trends, practices and developments in health care. Other duties as assigned within the scope of responsibilities and requirements of the job

Qualifications

  • Intermediate to advanced skills in Microsoft Excel, PowerPoint, and Word. (required)
  • One or more years of experience with advanced/complex SAS programming and application development (required)
  • Experience with different database systems such as MS SQL Server, Oracle, DB2, etc. (preferred)

Qualifications, Education and Experience

  • Bachelor’s Degree (required) or Master’s or above Degree (preferred), with focus on economics, statistics, informatics or other quantitative social sciences field (preferred)
  • 1+ years programming experience with SAS (required)
  • Certified Base and/or Advanced SAS programmer (preferred)
  • Ability to work independently to gather facts, organize/clean data, analyze data, and identify relevant issues (required)
  • Strong critical thinking and programming skills (required)
  • Advanced understanding of health care administrative data and complex healthcare databases (required)
  • Strong analytical skills set (required)
  • Strong writing and communication skills; ability to convey complex information in clear and concise manner (required)
  • Ability to work in a team, keeping project leaders updated on status of multiple projects (required)

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Senior Health Outcomes Researcher
closed

Company: Engage2Health, a Health Advocate Company

Location: Westlake Village, CA

Company Description:

Health Advocate, Inc., the nation?s leading independent healthcare advocacy and assistance company, serves 40 million Americans nationwide through its more than 8,500 client relationships. Engage2Health (e2H), a division of Health Advocate, specializes in health informatics and data-driven interventions with many years of combined clinical, quantitative and analytic expertise. E2H conducts health services and outcomes research within the private sector. Our research and development staff is made up of a group of highly motivated and innovative specialists with advanced degrees in medicine, health services research, epidemiology, mathematics and statistics. The team and this position will be based in Westlake Village, California, not far from Los Angeles.

Job Description:

The Senior Health Outcomes Researcher works with large claims databases, will conduct health outcomes research, develop predictive models and perform statistical analysis. Assists in developing outcomes research plans and outlines the strategic approach for generating required evidence and research outputs. The individual will participate in day-to-day operations, business development and client interactions.

Key Responsibilities:

  • Implement retrospective analyses through the design, collection and statistical analysis (in SAS) of databases.
  • Develop health economic models to perform cost-effectiveness and budget impact analyses.
  • Conduct primary research to evaluate adherence to evidence based medicine, including health economic endpoints and inform strategic recommendations
  • Develop health related communications, including dossiers, abstracts, manuscripts, posters, etc.
  • Conduct advanced health outcomes analysis using claims data, eligibility files and other ancillary data such as lab and pharmacy data
  • Conduct predictive modeling to identify populations at risk
  • Conduct sophisticated regression models and interprets results
  • Actively manage and lead client interactions regarding our informatics services
  • Provide research direction for the company and promote e2H externally through activities and presentations

Qualifications, Training and Experience:

  • Strong interest in and knowledge of biostatistics, research methods, epidemiology, modeling, and/or healthcare/pharmaceutical industry
  • Ph.D., in Statistics; Health Economics; Health Services Research, etc., with 2-3 years of experience is highly desirable
  • Master?s degree in Health Economics and outcomes Research (HEOR) related field and 4-5 years of experience conducting HEOR research (Related field include: Economics, Psychometrics, Health Policy and Outcomes Research).

Preferred:

  • Demonstrated problem solving, analytical reasoning, and decision-making skills
  • Strong multi-tasking and organizational abilities
  • Sense of urgency necessary to meet goals, objectives, and deadlines
  • Exercise independent judgment
  • Ability to multi-task, prioritize and manage complex projects and timelines in a matrix team environment
  • Ability to lead and coach others
  • Excellent interpersonal, verbal, and written communications skills
  • Demonstrated leadership abilities, accountability, and initiative
  • Proficiency in Microsoft Office (PowerPoint, Excel, Word)
  • Proficiency in SAS and/or STATA highly preferred

Compensation:

Includes a competitive base salary, incentives and a full employee benefits package.

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Senior Research Associate
open

Description

  • Complete client care searches as needed
  • Assist other research associates when needed
  • New hire mentoring regarding processes and procedures
  • Perform interim audits on new hires
  • Assist in development of unit training resources
  • Process all research types
  • Cross-train other research associates in other provider types – Behavioral Health, Benefits, Health Cost Estimates, Skilled Nursing, Home Health and Assisted Living
  • Monitor Manager’s dashboard – Assign, reassign, open and close search when supervisor is unavailable
  • Review and update policies and procedures
  • Participate in team meetings
  • Unit observation

Qualifications

  • High School diploma or equivalent
  • Understanding of basic medical terminology
  • Ability to work as part of a team
  • Effective communication skills
  • Well organized, meticulous attention to detail with ability to multi-task
  • Proficient computer skills (Microsoft Office, Excel, Outlook, Adobe PDF, Internet Searches)

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Senior Statistician
closed

Company: Engage2Health, a Health Advocate Company

Location: Westlake Village, CA

Company Description:

Engage2Health (e2H) is the analytics and informatics division of Health Advocate, Inc., a subsidiary of West Corporation. Health Advocate is the nation’s leading health care advocacy and assistance company, serving more than 9,000 clients and nearly 24 million people across the country. The company offers a range of personalized services to help employees and their families navigate the complex health and insurance systems. The ultimate goal is to help improve employee health care outcomes while simultaneously reducing medical expenditures.

In order to serve the needs of a diverse clientele, engage2Health specializes in health services and outcomes research and population management interventions. The e2H team integrates complex sources of health care data to provide customized solutions that promote quality and value in health care. The company is committed to the academic integrity of its programs and maintains a portfolio of peer-reviewed studies that adhere to rigorous scientific standards.

Job Description:

  • Work as part of a collaborative team in a dynamic environment as senior statistician methodologist
  • Provide statistical methodology and project management support for peer-reviewed level data analysis, both ongoing and custom studies
  • Develop tactical study plans in answer to business questions
  • Perform quantitative research, and provide written summaries of study results
  • Define research requirements, identify viable research designs, and design appropriate data collection strategies
  • Provide clients with relative costs and benefits of alternative approaches, and assist them in selecting approaches that maximize rigor within organizational constraints
  • Select and implement statistical analysis appropriate to the problems
  • Effectively communicate in written documents and oral briefings why studies were initiated, justification of methods selected, results, conclusions, and recommendations
  • Engage clients on design and methodological issues in a manner consistent with their needs and expectations
  • Evaluate the relative advantage of collecting new data versus using extant data
  • Define statistical design and methodology to meet client information needs
  • Conduct statistical analyses to derive conclusions, and identify new opportunities for standard reports and for value-added analytics
  • Consult with clients on design and methodology and provide input for client proposals
  • Work on projects of complex scope where independent judgment is used within a broad range of defined procedures and practices
  • Develop new applications and methodologies for existing or newly acquired data
  • Lead design efforts in selecting statistical methodology for use in the development and launch of new products

Key Responsibilities Include:

  • Conduct advanced health outcomes analysis using claims data, eligibility files and other ancillary data such as lab and pharmacy data
  • Participate in developing predictive modeling to identify populations at risk
  • Participate in creating sophisticated regression models and interprets results
  • Implement retrospective analyses through the design, collection and statistical analysis (in SAS) of databases using claims data
  • Prepare, write, and coauthor peer reviewed level manuscripts
  • Actively manage and lead client interactions regarding our data analyst services
  • Providing R&D direction for the company and promote e2H externally through activities and presentations
  • Develop health economic models to perform cost-effectiveness analyses

Required Qualifications:

  • Must have a minimum of 5 years' experience in advanced data analytics
  • Master's Degree in a field using advanced data analytics or a Ph.D. with three years of experience
  • Exceptionally strong methodological and analytic skills
  • Advanced proficiency in statistical programming software, (e.g. SAS, R, SPSS)
  • Experience working with Bayesian Methods
  • Excellent oral and written communication skills, including visual representation of data using charts and graphs
  • Ability to work under stringent deadlines, balance multiple tasks, and remain client focused

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Staffing Coordinator
open

Description

Health Advocate is seeking a Staffing Coordinator to recruit and hire screening staff to work our Onsite Biometric Screenings.

The Staffing Coordinator will assist the Project Manager to staff the onsite biometric screening events. The intent is to assist in delivering the highest quality service while adhering to the mission and goals Health Advocate has established to provide best in class wellness programs to its clients.

Essential Job Functions

  • Process requests from multiple project managers to help staff on site events
  • Access a database of vetted resources to evaluate availability of staff
  • Contact via phone and email staff available and coordinate on site dates and record results
  • Reach out to airlines, hotels, and other transportation and lodging resources to book travel arrangements
  • Compile reports on work tasks completed
  • Initial resume review and response
  • Professional license verification by issuing state
  • Research electronic timesheets over scheduled hours
  • Administrative support to Project Managers as needed
  • Ensure salesforce.com event data is accurate and up to date
  • Work with a team which fosters the delivery of high quality services and promotes exceptional customer service

Qualifications

  • Applicable work experience.
  • Proven system skills with emphasis on word, excel, access, etc.
  • Able to communicate directly with a variety of internal and external resources to complete multiple office tasks.
  • Able to understand confidential information and the implications of sharing such data.
  • Excellent interpersonal skills - with an emphasis on ability to communicate both verbally and in writing.
  • Ability to work in a team based environment required.
  • Problem solver
  • Experience working in a professional environmentComfortable navigating the internet

Preferred but not required background

  • Experience using Salesforce.com

Applications will be accepted through 09/16/15.

EEO/AAP Employer-Minorities/Women/Disabled/Protected Veterans

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Supervisor - Customer Service
open

Essential Job Functions:

  • Responsible for the administrative functions and supervision of the Triage/Intake unit. This includes backlog and quality management for a small team of customer Care Associates
  • Provide organization, direction and staffing for all assigned service calls and case load assistance to ensure that all calls are answered in accordance with Health Advocate’s policies and procedures
  • Monitor calls and audit case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed at or near the target resolution
  • Ensure assigned staff members meet or exceed the standards, results and responsibilities of their respective positions
  • Coach, mentor, and evaluate the performance of an assigned team
  • Assist in the selection, counseling, and discipline of all staff on the team
  • Provide oversight and direction to staff for assigned cases
  • Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts
  • Routinely evaluate and monitor service calls and case management procedures to recommend any necessary changes to the Director of Operations
  • Escalate cases through the appropriate channels in accordance with Health Advocate’s policies and procedures

Qualifications:

  • Bachelor’s Degree or applicable work experience
  • Management or supervisory experience in a Call Center setting (benefits and/or claims processing supervisory experience a plus)
  • Strong leadership skills and the ability to build effective teams
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing
  • Assertive, self-confident and resilient
  • Basic computer skills
  • Ability to search and identify resources through the internet
  • Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals
  • Familiarity with various types of health insurance coverage, coordination of benefits and UCR fees

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Web Developer
open

Description

  • Analyze business requirements and transform them into technical design
  • Using appropriate tools, design, build and enhance externally facing web sites using primarily ASP.NET and related technologies
  • Provide support for existing web sites that support the business
  • Proactively provide ideas and solutions towards the improvement of business operations

Qualifications

  • 4 years’ experience designing and developing software in an environment using a full software development lifecycle approach
  • Expertise in ASP.NET development using C#, demonstrating object-oriented, multi-tier architecture and design
  • Experience with front-end web development using valid XHTML, JavaScript, and CSS for positioning
  • Experience managing code releases and deploying production ready software systems
  • Experience in Waterfall and Agile development methodologies
  • Strong knowledge of SQL and experience developing data-driven web applications
  • Experience with third party controls like Telerik preferred
  • Experience developing .NET Windows applications is a plus
  • Strong analytic and problem solving skills and passion for the web
  • Excellent communications and project management skills
  • College degree preferred
  • Ability to interact effectively with peers, business users and all levels of management
  • Ability to work with minimal supervision in a fast paced, dynamic environment
  • Knowledge of latest web technologies is required, as is a genuine interest in leveraging technology effectively for the good of the company

Click to view the job on the West Careers portal and to apply online.

About Health Advocate
Wellness Coach (Evening)
open

Description

Our Wellness Coaches assist members in establishing and meeting healthy goals that lead to life style improvement through frequent verbal and written communication.

Major Job Accountabilities

Wellness Coach Functions - Assist members in establishing and meeting healthy goals that lead to life style improvement through frequent verbal and written communication.

  • Provide email and telephonic coaching to members
  • Follow coaching protocols and operational processes
  • Serve as a supporter, guide and educator for members for Coaching issues and client incentives
  • In collaboration with members, identify and target behavioral changes and establish goals and action plans
  • Assist members in updating/modifying their goals and actions plans
  • Take proactive steps to maintain member engagement
  • Actively participate in training sessions
  • Able to recognize problems and develop appropriate solutions
  • Assist with Advocacy Issues as required.

Team Interfaces/Customer Service - Establish and maintain a professional relationship with internal/external customers, team members and department contacts

  • Cooperate with team members to meet goals or complete tasks
  • Provide quality customer service that exceeds customer expectations and improves level of service being provided
  • Treat all internal/external customers, team members and department contacts with dignity/respect
  • Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided

Mental and Physical Requirements

  • This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers
  • The nature of the work in this position is sedentary and the incumbent will be sitting most of the time.
  • Essential physical functions of the job include typing, grasping, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
  • Essential mental functions of this position include concentrating on tasks, time management , reading information, and verbal/written communication to others continuously throughout the work day

Related Duties as Assigned

  • The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents
  • Consequently, job incumbents may be asked to perform other duties as required
  • Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above
  • Please contact your local Employee Relations representative to request a review of any such accommodations

Qualifications

Applicant for this job will be expected to meet the following minimum qualifications.

  • Strong computer skills including use of internet and email
  • Positive attitude and belief in a person’s ability to change
  • Good active listening skills
  • Proven record of ability to develop relationships with client
  • Effective writing skills, including appropriate spelling and grammar
  • Organized and self-directed

Education

  • Bachelor’s Degree in health, fitness or other related fields

Experience

  • Experience in health/fitness related fields

Other

  • Must score acceptably on job related testing
  • Based on program may need to be bilingual in English, Spanish, etc.

Click to view the job on the West Careers portal and to apply online.

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