会员护理倡导者（MCA）- 9月班次
Member Care Advocate (MCA) - September Cohort
关于 Included Health
Included Health 是一家新型的医疗公司，提供整合的虚拟护理和导航服务。我们的使命是为每个人提升医疗标准。我们打破障碍，为每个社区中的每个人提供高质量的护理——无论他们处于健康旅程的哪个阶段，需要哪种类型的护理，从急性到慢性，行为到身体。我们为会员提供护理指导、倡导和个性化虚拟及面对面护理的访问权限，包括日常和紧急护理、初级护理、心理健康和专科护理。一切皆包含在内。了解更多信息，请访问 includedhealth.com。
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Included Health 是平等机会雇主，在招聘时不考虑种族、肤色、宗教、性别、性取向、国籍、年龄、残疾、基因或其他联邦、州或地方法律禁止的任何因素。Included Health 根据旧金山公平机会条例、洛杉矶县公平机会条例和加州法律，考虑所有符合条件的申请人，包括有逮捕或定罪记录的申请人。
职责
- 在高流量环境中提供以会员为中心的支持：
- 以尊重和同理心的方式接听来电和聊天，使用清晰易懂的语言，帮助会员感到自信和知情。
- 解决核心会员问题：
- 解释福利覆盖范围、费用分担概念（免赔额、共付额、共同保险和自付上限）和基本资格详情。
- 寻找并确认网络内供应商，更新账户信息，并提供现有请求的简单状态更新。
- 通过指导他们完成标准注册或预约步骤，将会员与可用项目（如虚拟护理）连接起来。
- 独立处理问题并赋能会员：
- 使用既定的工作流程和脚本端到端解决明确的问题，同时教育会员以减少未来的困惑和重复联系。
- 利用工具和资源：
- 在 Included Health 系统、知识库和保险公司门户中导航，以研究问题并确定下一步行动。
- 准确记录互动和后续行动，确保清晰简洁的笔记，以便团队之间实现护理连续性。
- 提供一致的高质量服务：
- 达到或超越质量审核和会员满意度（MSAT）的期望，同时清晰阐述 Included Health 的使命和对减少摩擦的承诺。
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About Included Health
Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com.
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Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law.
Responsibilities
- Provide Member-Centered Support in a High-Volume Environment:
- Answer inbound calls and chats respectfully and empathetically, using clear, plain language to help members feel confident and informed.
- Resolve Core Member Issues:
- Explaining benefits coverage, cost-sharing concepts (deductibles, copays, coinsurance, and out-of-pocket maximums), and basic eligibility details.
- Finding and confirming in-network providers, updating account information, and providing simple status updates on existing requests.
- Connecting members to available programs (such as virtual care) by guiding them through standard enrollment or scheduling steps.
- Own Issues and Empower Members:
- Resolve clearly defined questions end-to-end using established workflows and scripting, while educating members to reduce future confusion and repeat contacts.
- Leverage Tools and Resources:
- Navigate Included Health systems, knowledge bases, and carrier portals to research questions and identify the right next step.
- Accurately document interactions and follow-up actions, ensuring clear, concise notes that enable continuity of care across the team.
- Deliver Consistent Quality:
- Meet or exceed expectations for quality audits and member satisfaction (MSAT), while clearly articulating Included Health's mission and commitment to reducing friction in healthcare.
Qualifications
- Bachelor's degree with a minimum of 2 years of customer service or healthcare experience, OR 5 years of relevant experience in healthcare or benefits navigation.
- Comfortable handling a high volume of inbound calls throughout the day using VoIP phone systems (e.g., CXOne).
- Strong familiarity with Google Workspace, Apple products, and customer relationship management (CRM) software, with the ability to learn proprietary tools quickly.
- Exceptional customer service skills, with the ability to act as a member advocate, de-escalate challenging situations, and maintain a professional, friendly demeanor.
- Strong verbal communication skills for phone interactions, including the ability to explain benefits, processes, and next steps clearly and confidently.
- Strong written communication skills in English for accurate, clear documentation of member interactions.
- Demonstrated ability to think critically within defined workflows, identify when something doesn't look right, and use available resources to resolve well-scoped issues.
- Comfortable gathering information, asking clarifying questions, and structuring a clear summary when additional follow-up by other teams is needed.
- Understands and follows HIPAA guidelines and maintains member confidentiality at all times.
- Ability to work from a secure, distraction-free home office with reliable internet, and the discipline to succeed in a remote environment.
- Must be able to complete the 3-week paid training period with no planned time off permitted. Training is 10 a.m. - 7 p.m. EST Monday - Friday.