Health Pro Consultant - US Virtual

About the Role

The role entails working closely with members to understand their needs and provide personalized support. You will have the opportunity to work with a range of healthcare professionals, including doctors, nurses, and other specialists, to ensure that members receive the best possible care. Your primary responsibility will be to advocate for members, helping them to navigate the healthcare system and access the services they need.

What You Will Do

• Gather information about the reason members are seeking support or care
• Educate members on benefit programs provided by clients
• Translate complex benefit details into clear, actionable guidance
• Deliver provider recommendations, referral guidance, and connections to clinical or employer-sponsored programs
• Complete cost estimates and communicate out-of-pocket responsibility, claim results, denials, appeals, and escalation outcomes
• Explain prescription formulary options, prescription alternatives, prior authorization outcomes, and available cost-saving opportunities
• Proactively identify unmet clinical needs and own the connection to appropriate clinical support and care resources
• Connect members to company-sponsored health and benefits programs
• Collaborate with healthcare professionals to ensure members receive the best possible care
• Stay up-to-date with industry developments and best practices in healthcare
• Participate in ongoing training and professional development to enhance skills and knowledge

What We Are Looking For

• 2+ years of experience in a related field, such as healthcare or customer service
• Strong communication and interpersonal skills
• Ability to work independently and as part of a team
• Strong problem-solving and analytical skills
• Ability to navigate complex healthcare systems and provide support to members
• Strong knowledge of health benefits and healthcare systems
• Experience with healthcare software and technology
• Certification in a related field, such as nursing or healthcare administration
• Strong attention to detail and organizational skills

Nice to Have

• Experience working in a remote or virtual environment
• Knowledge of healthcare regulations and laws
• Experience with electronic health records (EHRs)
• Certification in a specialty area, such as case management or patient advocacy
• Bilingual or multilingual skills

Benefits and Perks

• Competitive total rewards package
• Comprehensive health, dental, and vision insurance
• 401(k) plan with corporate match
• Paid time off and holidays
• Flexible working arrangements, including remote work options
• Ongoing training and professional development opportunities
• Collaborative and dynamic work environment
• Opportunity to work with a diverse range of clients and members

• Be prepared to talk about your experience working with healthcare systems and supporting members with complex healthcare needs.
• Highlight your ability to work independently and as part of a team, as well as your strong communication and interpersonal skills.
• Make sure to research Alight Solutions and its values, and be prepared to discuss how you embody the principles of Championing People, Growing with Purpose, and Being Alight.
• Consider creating a portfolio that showcases your experience and skills in healthcare, and be prepared to discuss your approach to patient-centered care.
• Don't be afraid to ask questions about the role and the company, and be prepared to discuss your long-term career goals and how this role fits into your overall career aspirations.
• Be prepared to discuss your experience with healthcare software and technology, and your ability to navigate complex healthcare systems.