Job Description

If you enjoy a fast pace, new opportunities every day and a people-focused team, Specialist Management Solutions (SMS), owned by SCA Health, a division of United Health Group, is the organization for you. The SMS program, which provides specialty and surgical care support, is growing and SMS needs energetic and passionate team members to help drive continued success.

The mission of SMS is to simplify surgical care for all people by removing barriers, educating people, and providing high quality care. The SMS model provides a simple solution to large, self-insured employers to drive down outpatient surgical and specialty care spend via a concierge model that is built around an engaging, educational and exceptional membership experience.

SMS helps connect members to specialty and outpatient surgical care and supports the member throughout their care journey, including locating a provider and scheduling consultations, surgeries and follow-up.

As a Senior Care Advocate you will be the face of Specialist Management Solutions (SMS) to our customers. This is a Medical Concierge (White Glove) service where you’ll deliver a personized, empathetic consumer experience as they navigate the complexity of the healthcare system. This will include answering questions and resolving issues in collaboration with teams across the company, healthcare providers, and insurance companies. You will be primarily engaging with our customers telephonically, but you will develop strong relationships with them as they complete their healthcare journey.

The role involves conducting outbound cold calls to inform members about their SMS benefits, educate them on the advantages of utilizing Ambulatory Surgery Centers (ASCs), and encourage members to schedule appointments, fostering a deeper understanding of SMS services and proactive healthcare engagement.

A successful Sr. Care Advocate will effectively communicate the value of SMS benefits, clearly explain the advantages of utilizing Ambulatory Surgery Centers (ASCs), and proactively encourage members to schedule appointments. They will demonstrate strong interpersonal skills, maintain a member-focused approach, and consistently meet outreach and engagement goals.

** The work schedule will be Monday - Friday from 11:30am - 8pm EST / 10:30am - 7pm CST **

Responsibilities

• Predominate amount of work surrounding calling members (Outbound calls) to inform them of their benefits and act as a care guide on behalf of the customer helping them receive treatment from a network of high-quality surgeons
• Receive inbound calls from members to educate them on their benefits and provide guidance with appointment scheduling
• Assist in the coordination of care across a variety of settings, while maintaining strict confidentiality and the highest level of professionalism
• Update all systems accordingly to document member engagement
• Listen to member’s comments, concerns, and suggestions, relaying that information internally, while ensuring member satisfaction
• Collaborate with other departments and partnering companies as necessary
• Work with health insurance counterparts to answer customer questions related to benefits, claims, and billing
• Analyze a variety of problems and provide information/solutions
• Work within a team to achieve performance targets
• Other responsibilities as assigned

• High school diploma or higher education
• At least 3+ years of customer service / Sales experience
• Must be comfortable making outbound cold calls to schedule medical appointments
• Customer-centric focus with excellent communications skills
• Express empathy with customers & compassion for their challenges
• Passion for healthcare improvement
• Ability to work independently and in small team
• Agility- Ability to change direction quickly
• Time management / task management
• Knowledge of care coordination and case management concepts is preferred.
• Bilingual language skills preferred (English-Spanish or other)

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