Rely Health

Role Description The Lead Remote Navigator provides day-to-day leadership and operational oversight to a team of Remote Navigators across multiple service lines in a call center or distributed remote environment. This role balances direct call handling and queue coverage with team coordination, performance monitoring, training, scheduling, and timecard approval. The Lead Navigator is responsible for resolving team escalations within established workflows in collaboration with the Manager, and reporting new or emerging issues to the Manager with proposed solutions. The Lead Remote Navigator ensures that navigators are meeting service level and quality metrics, adhering to workflows, and delivering a high-quality patient experience over the phone and through digital channels. This role leads training and onboarding, creates and manages team schedules, holds weekly supervision with direct reports, approves timecards, and participates in the Training & Development committee and implementation working groups in a leadership capacity. The Lead Remote Navigator is also a power user and internal champion of the AI tools that augment navigator workflows, providing structured feedback to Product and Operations on tool performance. What you'll do - Escalation Handling - Handles escalated patient and family calls from Remote Navigators. - For issues within existing workflows: resolves escalations with feedback and ensures proper documentation. - For new or emerging issues: reports to Manager/Supervisor and collaborates on developing solutions. - Direct Patient Navigation - Maintains a direct call handling function across 3+ service lines as needed to maintain queue coverage. - Provides advanced care coordination across complex patient pathways using digital and AI-enabled workflows. - Serves as backup to the call queue to maintain service levels during high-volume periods. - Ensures team adherence to HIPAA requirements and all program standards. - Monitors patient data and metrics to identify care gaps and guide team outreach strategies. - Collaborates with AI tools to streamline patient interactions and prioritize higher-acuity cases. - Contributes to an environment of psychological safety where ideas are welcomed and appreciated. - Client Communication - Acts as an indirect communication link between client site partners and Rely Health leadership — all client-facing program requests are channeled appropriately through established protocols. - People Management - Holds Bi-weekly supervision meetings with all direct reports to review performance, provide feedback, and support professional development. - Creates and manages call center shift schedules, adjusting as needed to ensure full queue coverage across all service lines. - Reviews and approves timecards for all direct reports. - Monitors day-to-day remote team operations and serves as the first internal point of contact for team members. - Coordinates and supports recruitment, onboarding, and training of new remote navigators. - Conducts quality audits of remote navigator performance using call recordings, documentation review, and metric analysis. - Provides real-time service recovery when patient concerns arise, implementing coaching and process improvement plans. - Collaborates with Manager on performance reviews and developmental feedback. - Communicates employee changes to Human Resources in coordination with Supervisor. - Training - Supports implementation of program expansion and new client site initiatives. - Trains new Navigator team members on remote workflows, call center tools, role expectations, and digital platforms. - Evaluates performance during onboarding and provides structured feedback. - Creates training content for remote workflows, digital communication tools, and AI platform use. - Coordinates group workshops and team workgroups. - Leads participation in the Training & Development committee and implementation working groups, driving initiatives from the remote navigation perspective. - Technology - Monitors team technology usage and call center metrics in Rely Health tools, reporting results to leadership and clients as needed. - Works with Operations and Product teams to test new digital tool enhancements and provide structured feedback. - Ensures all team members are trained and proficient on required technology platforms. - Provides actionable remote usability feedback on AI, call center, and care navigation tools. - Conducts testing on new call center tools and features prior to team rollout. - Uses no-code tools to build or adjust basic campaigns, reminders, or engagement workflows as directed. - Serves as power user and internal champion for AI tools that augment navigator workflows. - Identifies opportunities to optimize AI tool prompts, scripts, and configurations based on observed patient outcomes and call center performance data. Qualifications - High school diploma or GED. - 2+ years of full-time equivalent experience in patient care navigation, call center navigation, or related healthcare coordination role. - 1+ years leading or mentoring a team. - Experience training other employees. - Healthcare experience. - Familiarity with healthcare technology platforms and tools. - Ability to maintain high productivity in a remote or distributed work setting. - Understanding of and ability to comply with all HIPAA and confidentiality requirements. Preferred Qualifications - Experience working with individuals within hospitals or public health settings. - Experience with underserved populations. - Knowledge of Medicare, Medicaid, and commercially insured payer common practices and policies. - Individuals with lived experience. - 40+ wpm typing proficiency. - EHR/EMR or call center CRM documentation experience. - Experience using technology, apps, and software. - Experience with AI-assisted care tools or digital health platforms. - Bilingual proficiency is a plus. Competencies (Knowledge / Skills / Abilities) - Knowledge of medical terminology. - Knowledge of HIPAA and Protected Health Information (PHI) rules and practices. - Proficiency in Microsoft Office, Google Suite, and video conferencing. - Active listening, de-escalation, and motivational interviewing skills. - Ability to manage complex, multi-stakeholder care cases independently. - Ability to maintain a high level of productivity autonomously. - Data analysis skills — ability to identify care gaps and drive metric-based outreach. - Deeper knowledge of insurance, billing, and healthcare systems. - Flexible and creative problem-solving. - Dynamic communication skills in a virtual and phone-based environment. - Analytical skills — ability to translate call metrics and patient data into team performance action. - Ability to monitor, coach, and hold accountable a distributed remote team. - Proficiency in remote collaboration tools, queue management systems, and digital platforms. - Ability to build and implement new remote processes and tools. - Strong organizational, scheduling, and queue management skills. - Ability to drive high performance, culture, and employee engagement in a virtual setting. - Empathetic critical thinking and collaborative remote leadership style. - Strong interpersonal skills — ability to establish trust and credibility as a peer and leader across a remote team. - Ability to thrive and hold others accountable in a performance-based environment. Benefits - 401(k) - Dental insurance - Health insurance - Vision insurance - LT/ST Disability and Life Insurance - Technology reimbursement - Paid time off (Vacation, Sick, Holiday) - Paid Parental leave - Professional development

Role Description The Care Advocate guides patients and their families throughout the patient’s care journey by combining human interaction and technological tools to facilitate a seamless experience during the initial intake process through their journey to and from their appointments. The Care Advocate helps reduce worry and frustration for patients, families, and caregivers by increasing communication, coordination, and efficiency across the healthcare and transportation system. - Assist patients with completing all medical forms for the clinic through the use of technology. - Obtain referrals or authorizations. - Arrange transportation. - Contact patients prior to appointments as needed to ensure follow-through. - Document activities of patient advocacy. - Maintain knowledge of and collaborate with local healthcare-related resources and insurance plans. - Keep patients, their families, and caregivers apprised of care management. - Act as a personal patient concierge with strong customer service and communication skills. - Understand patient and/or provider requests and connect patients to the appropriate resource. - Success based on results-oriented goals and metrics. Qualifications - High school diploma or GED. - Experience in healthcare, home health, managed care, behavioral health, population health, or care coordination environments. - Experience working in high-accountability remote operations environments. - Ability to maintain a high level of productivity autonomously. - Experience working in a call center environment. Requirements - Bilingual communication skills (preferred). - Familiarity with patient outreach workflows, appointment coordination, referral management, or engagement programs (preferred). - Experience with underserved populations (preferred). - Knowledge of Medicare, Medicaid, and commercially insured payer common practices and policies (preferred). - 40+ wpm typing proficiency (preferred). - Experience documenting in electronic health record system or similar (preferred). - Experience using AI technology, apps, software (preferred). Benefits - 401(k) - Dental insurance - Health insurance - Vision insurance - LT/ST Disability and Life Insurance - Technology reimbursement - Paid time off (Vacation, Sick, Holiday) - Paid Parental leave - Professional development