3 Advocate South Suburban Hospital jobs in Calumet City

Job Description

Job Description

Contact Center Patient Advocate

What we are looking for
We are seeking a Patient Advocate for our Contact Center in Berwyn, PA. This pivotal role serves as the primary point of contact between AscellaHealth and the stakeholders we support, including patients, healthcare providers, pharmacies, and health plans. This frontline role is essential in delivering white-glove customer service and ensuring a seamless, compassionate experience for patients throughout their treatment journey.

The Patient Advocate is responsible for facilitating timely access to prescribed medications, conducting outbound calls, receiving inbound inquiries, and addressing questions with professionalism and empathy. A core function of this role is to remove barriers to access, ensuring the patient journey is effortless from the doctor writing the prescription to its delivery.

The role is based in our Berwyn, PA office. This position will require to be in the office 5 days a week, Monday through Friday, for the first 90 days for training purposes. After that, it will be a hybrid role that requires in-office work three (3) days per week.

What the position will be doing

• Serve as the primary point of contact for patients, providers, pharmacies, and health plans, while delivering concierge-level service and support.
• Conduct inbound/outbound calls and texts to facilitate the patient journey and ensure timely access to prescribed medications.
• Coordinate benefits investigations and work with pharmacy and medical benefit payers to secure coverage and approvals for therapies.
• Assist patients with enrollment in financial assistance programs, including manufacturer copay cards, foundation assistance, or patient assistance programs (PAPs).
• Provide clear, compassionate guidance to patients, addressing questions and concerns to reduce barriers and support adherence.
• Track, log, and resolve all communications and actions in the contact management system with accuracy and timeliness.
• Collaborate with internal teams and external partners to streamline processes and ensure efficient medication fulfillment and delivery.
• Monitor patient cases from initiation to resolution, ensuring follow-ups are conducted and updates are communicated promptly.
• Escalate complex or unresolved issues to the appropriate internal stakeholders while maintaining ownership of the patient experience.
• Perform other related duties as assigned or necessary; remain flexible and adaptable in work schedules and assignments as defined by departmental and organizational needs.

Necessary Skills, Education & Abilities

• A high school diploma or equivalent is required; an Associate's or Bachelor's degree in healthcare, communications, or a related field is preferred.
• Two (2) or more years of experience in a healthcare contact center, patient support, specialty pharmacy, or related customer service role.
• Experience working with healthcare stakeholders such as patients, providers, pharmacies, and/or health plans.
• Familiarity with medical and pharmacy benefits, prior authorization processes, and financial assistance programs preferred.
• The ability to speak English and one or more additional languages is a plus.
• Excellent oral communication skills with a compassionate and patient-centered approach.
• Demonstrated ability to deliver concierge-level customer service in a fast-paced environment.
• High attention to detail and organizational skills with the ability to manage multiple cases and priorities simultaneously.
• Strong interpersonal skills and the ability to work independently and effectively in a team setting.
• Dependable and punctual, flexible to work shifts as needed, including evenings or weekends, based on patient and business needs.
• Problem-solving mindset with the ability to de-escalate issues and find solutions quickly and effectively.
• The ability to handle sensitive and confidential information with professionalism and discretion.
• Commitment to maintaining a positive and empathetic attitude in all interactions.
• Able to thrive in a fast-paced environment with constantly changing priorities, flexible and adaptive to changing processes and procedures.
• Self-motivated and able to thrive in a results-driven environment.
• Proficient in Microsoft Office Suite, Excel, Word, PowerPoint, and Outlook

About us
AscellaHealth is a global Specialty Pharmaceutical and Healthcare services organization serving patients, payers, life sciences, and providers, offering a comprehensive portfolio of customized, tech-enabled specialty pharmaceutical and medical management services. An Inc. 5000 2022 winner, AscellaHealth’s unique, patient-centric approach supports its strategic partnership with Optime Care and is built upon proprietary technology processes for innovative programs and services optimizing health outcomes and quality of life for patients with complex, chronic conditions or rare diseases that require specialty medications and/or gene and cell therapies. Visit
 

AscellaHealth provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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Overview
As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home.
It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you?
**Showing Up Somatus Strong**
We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make:
+ **Authenticity:** We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say.
+ **Collaboration:** We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more.
+ **Empowerment:** We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients' lives or our partners' best interests.
+ **Innovation:** We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions.
+ **Tenacity:** We see challenges as opportunities for growth and improvement - especially when new solutions will make a difference for our patients and partners.
**Showing Up for You**
We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including:
+ Subsidized, personal healthcare coverage (medical, dental vision)
+ Accrual of 3 weeks' Vacation (PTO)
+ Professional Development, CEU, and Tuition Reimbursement
+ Curated Wellness Benefits supporting teammates physical and mental well-being
+ Community engagement opportunities
+ And more!
**Somatus offers a Hybrid Telehealth environment with a combination of remote days and visits to members' homes.**
This position will be focused on high needs Chronic Kidney Disease (CKD) and End-Stage Kidney Disease (ESKD) populations that face multiple challenges, from accessing resources to adhering to a physician's treatment plan. The CHW-Patient Advocate will work as an extension of the clinical care team, specifically under the guidance of RN Care Manager and act as an advocate guiding them through their care needs. The individual taking this role will manage his/her caseload through in-person, telephonic and electronic means of communications and coordination. The Patient Advocate will be the first and primary representative of Somatus to our members. He/she will be the key holder of the patient relationship and trust and will be responsible for building this relationship. He or she will be tasked as the person that schedules the initial wellness exam and care management assessment meeting with Somatus clinicians. After an individual care plan is developed, will be the person that facilitates connecting and scheduling the many resources within and beyond Somatus to the patient (including the various members of our care team as well as PCPs, Nephrologists etc). The Patient Advocate will also be involved in the community to "plug in" the patient with others and help facilitate their overall wellbeing. This position is a market-based position.
Responsibilities
+ Works under the guidance of physicians and/or a nurse care manager.
+ Follow-up with health management plans and goals.
+ Establish positive, supportive relationships with participants and provide feedback.
+ Conduct an initial triage assessment to help align patients with the most appropriate program inaccordance with program guidelines.
+ Documents their activities in the care coordination platform, including care plan activities conducted.
+ Engages with patients who need assistance with self-care needs in addition to what a nurse care manager can provide via phone, such as:
+ Address language and cultural barriers to care management and self-care.
+ Coach and guide the patient to meet both personal and clinical goals.
+ Schedules provider appointments on behalf of their patients.
+ Accompanies patients to their appointments when needed.
+ Reminds patients of their upcoming appointments.
+ Helps patients access community and government-based services, including possibly filling out paperwork for the patient.
+ Helps to teach the caregiver about symptom response plans.
+ Arranges transportation.
+ Facilitates closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing.
+ Assists patients with enrolling to access educational videos.
+ Participates in the integrated care team meetings.
+ Act as the patient advocate and support the member through their patient journey starting with initial outreach.
+ Conduct telephonic outreach to members within designated geographic area to introduce the Somatus program and encourage enrollment to build their patient caseload.
+ Conduct door-to-door engagement outreach for patients with telephonic barriers.
+ Support NP and RNCM care team members through facilitating in home telehealth visits with patients.
+ Utilize motivational interviewing techniques to encourage patients to make behavioral changes.
Measures of Success
+ Patient Engagement
+ Care Setting Transitions
+ Assessment
+ Monthly Goal completion as set by the RNCM
+ Patient Success - as measured by no/reduced hospital or ER visits on a monthly basis
_Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice._
Qualifications
Required
+ Experience working with Medicare, Medicaid or Special Needs populations.
+ Medical Assistant, Licensed Practical Nurse, Engagement Specialist or Community Health Worker Experience.
+ Must be fluent in both English and Spanish
+ Ability to connect with people and understand the challenges they face.
+ Ability to use a range of outreach methods to engage individuals and groups in diverse settings.
+ Well connected to the community and resources within the community they will serve.
+ Effective written and verbal communication skills demonstrating respect and cultural awareness during interactions with clients.
+ Access to reliable transportation for travel within the assigned region and comfort with conducting home visits (50-75% same day travel).
+ Great motivator
+ Organized Coach
+ Empathetic
+ Outgoing / positive personality
Preferred
+ Experience working with patients with chronic and behavioral health needs.
+ Demonstrated success in working as part of a multi-disciplinary team including communicating and working with Physicians and Registered Nurses.
+ Proven experience with engaging patients in making healthy behavior changes.
+ Proven skills in navigating the health systems and making necessary linkages in order to meet specific needs.
+ Experience working with Electronic Medical Records and other documentation platform.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law. All requests for proof of vaccination or for exemptions from the vaccination requirement will be subject to any limitations stipulated by current state and/or federal laws.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.