Member Care Navigator I

Uprise Health

. Promptly answer, screen, and triage inbound telephone calls .

Posted 10/15/2026contractRemote • United StatesMid-LevelSenior💰 $22 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong customer service and problem-solving skills while effectively managing inbound and outbound communications in a behavioral health environment. Proficient in documenting interactions and navigating proprietary systems while upholding HIPAA standards.

Highest-signal resume keywords

Customer Service SkillsBehavioral Health ExperienceHIPAA ComplianceMicrosoft Office ProficiencyBilingual Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Call ScreeningDemographic VerificationReferral ResearchAppointment SchedulingDocumentation Accuracy

Soft Skills

Problem SolvingCommunication SkillsAdaptability

Tools & Technologies

Uprise Health SystemQuickCapMicrosoft WordMicrosoft ExcelMicrosoft Outlook

Industry Keywords

Behavioral HealthCritical Incident ResponseManagement ReferralClient CoordinationPST Hours

About the role

Key responsibilities & impact

Promptly answer, screen, and triage inbound telephone calls
Verify and/or collect caller demographic information
Quote member benefits
Research and provide routine referrals based on members’ specific needs and location
Answer and triage questions related to authorizations, benefits, claims, and incentives
Document all activities fully and accurately in Uprise Health’s proprietary system
Make outbound enrollment calls, explain program components and incentives, and schedule appointments
Assist members and/or providers with website registration and navigation
Respond to Critical Incident Response (CIR) requests
Respond to Management Referral (MR) requests
Contact Client HR or designee to gather CIR/MR information
Coordinate with Uprise provider to deliver services
Inform Client HR/designee of CIR/MR confirmation and details
Enter details in QuickCap
Perform other responsibilities as assigned

Requirements

What you’ll need

High school diploma or general educational diploma (GED) required
Microsoft Word, Outlook, Excel and Internet Competence
Experience working in a behavioral health environment
Excellent customer service and problem solving skills required
Ability to learn new computer systems rapidly and accurately and completely document all activities and call content in the system
Working knowledge of Microsoft applications including Word, Excel and Outlook required
Ability to uphold all HIPAA standards and requirements
Bilingual preferred
Preference given to candidates on the West Coast to accommodate PST hours