Job Description

Therapy Management

• Accept ownership for managing new and existing therapy requests.
• Comprehensively assess member treatment needs and collaborate with providers and specialty pharmacies to prioritize member’s therapy needs.
• Maintain accurate and thorough documentation of all interactions and therapy updates.
• Continuously monitor and evaluate member's therapy plans and progress.
• Balance multiple responsibilities including case management, and inbound and outbound contact while demonstrating skill flexibility to ensure seamless service delivery.

Member Advocacy

• Take the time to understand each member's unique needs, preferences, and circumstances.
• Advocate for members' needs and preferences in therapy decision-making processes.
• Assist members in navigating barriers and explain their options for receiving their medications.
• Provide members with information and resources to help them make informed decisions about their therapy options. Empower members to participate in their treatment planning and decision-making process actively.
• Advocate for adjustments to therapy plans or additional support services if needed to optimize outcomes and ensure members receive the care they need.

Case Resolution and Problem-Solving

• Resolve member cases and inquiries in a timely and efficient manner, demonstrating strong critical thinking skills and attention to detail.
• Review and resolve next-level questions or concerns from members, providers, and pharmacies.
• Critically evaluate scenarios, anticipate potential challenges, and adapt your approach to meet member's evolving needs effectively.

Communication and Collaboration

• Communicate member progress by proactively informing members of their therapy status, and therapy options and intervening in crises for the member providing personalized communication.
• Manage communication with providers and consistently ensure professional and empathetic communication, fostering positive relationships and ensuring a high level of member satisfaction.
• Work closely with other departments to coordinate resources and address member inquiries or concerns effectively.

Qualifications

• Have at least 3 years of experience in the healthcare industry, focusing on care coordination , member advocacy, or related roles.
• Demonstrate 3 or more years of customer service experience, case management preferably in healthcare. Call center experience is a plus.
• Proven experience working in a high-volume, fast-paced, evolving team environment.
• Ability to problem-solve, positively adapt to changing working conditions and multi-task.
• You are passionate about improving healthcare and helping people and have demonstrated success in a similar role.
• You are an exceptional communicator who can quickly get up to speed with the VIVIO Health program and effectively articulate its benefits.
• You are responsible and reliable and take ownership of your work while looking to constantly improve your performance.
• High attention to detail
• Experience with Amazon Connect is desirable
• High school diploma or GED.
• Available to work a full-time role between the hours of 6 am PT- 5 pm PT (9 am ET-8 pm ET)
• Bilingual is a plus.

Additional Information

• Base pay $20/hour
• Full time
• Bonus Eligible
• Health Benefits
• PTO
• 401 K
• Opportunity to work for a growing and innovative company.
• Dynamic and collaborative work environment.
• The chance to make a real impact with a Public Benefit Corporation.

VIVIO Health is an Equal Opportunity Employer and does not unlawfully discriminate on the basis of any status or condition protected by applicable federal, state, or local municipal law. All your information will be kept confidential according to EEO guidelines.