Virtual Clinical Operations Jobs in Virginia (NOW HIRING)

About Crossover Health
Crossover Health is creating the future of health as it should be. A national, team-based medical group with a focus on wellbeing and prevention that extends beyond traditional sick care, the company delivers an entirely new model of healthcare-Primary Health-built on the foundation of trusted relationships, an interdisciplinary care team approach, and outcomes-based payment. Crossover's Primary Health model integrates primary care, physical medicine, mental health, health coaching, care navigation and more, and delivers care in surround-sound-in-person, virtually and via asynchronous messaging. Together we are building a community of members that embraces healthcare as a proactive part of their lifestyle.
Job Summary
Job Responsibilities The Virtual Care navigator plays a key part in delivering an exceptional member service experience. As an integral member of our Virtual Care team, the Virtual Care Navigator works closely with providers and staff to ensure an exceptional seamless patient-centered care experience. The role requires a collaborative mindset, flexibility, and a willingness to take on key tasks to ensure the smooth operation of the virtual clinic, along with a strong commitment to delivering high-quality patient care and outcomes. Additionally, for patients who need in-person care outside of Crossover's Virtual clinic, the Virtual Care Navigator will be cross-trained to manage, update and curate a network of medical specialists in the community who will partner with us to coordinate and deliver excellent care, taking over full logistical and workflow ownership of the referral process. The focus is on demonstrated high-quality care, patient experience, practice efficiency, cost effectiveness, and a service level consistent with Crossover Health standards. This will include capturing all incoming clinic requests for referrals, managing the scheduling and appointment creation for all referrals, communications between patient, specialist, and Crossover, and documentation in the appropriate tools. • Collaborate with providers and staff members to deliver an exceptional seamless patient-centered care experience. • Demonstrate a commitment to quality, delivering uncompromised service and outcomes. • Engage with members by answering all incoming calls, scheduling appointments, responding to messages, and following up with member needs. • Manage all aspects of scheduling for the virtual team including creating and publishing schedule templates, auditing schedules daily, checking in members, sending appointment reminders, and rescheduling appointments as needed. • Collaborate with virtual providers to prioritize and respond appropriately to messages in the queue ensuring that members receive timely responses. • Properly assign and file incoming faxes. • Handle the records request process from start to finish. • Assist with prior authorizations as needed. • Collect copays and answer all member questions related to insurance coverage and cost of care. • Demonstrate an in-depth knowledge of employer-sponsored health insurance, including copays, co-insurance, and related benefit specific requirements, in order to support members. • Accommodate special requests for member support whenever possible and help to promptly resolve member questions. • Assist with assigned projects and provider or patient requests. • Process referrals to secondary care, outside of Crossover Health (specialists, imaging, community resources, employer benefits). • Maintain ongoing communication, tracking, and appropriate documentation on referrals to ensure continuity of care. This tracking may use an IT database. • Ensure that referrals are addressed in a timely manner. • Assist with training relevant stakeholders (MDs and CNs) on the external referral process. • Be the single point of contact between specialists, the clinic physicians, and the patients when care is needed outside of a Crossover Health clinic, and provide updates as appropriate to the clinical team to ensure visibility into active referrals. • Use clinical judgment and critical thinking to discern and refine the correct provider type and stratify the urgency of the referral, in consultation with clinical team members when necessary. • Generate a complete referral packet and ensure timely submission to the specialist of the appropriate clinical documents to support the request for the referral (pertinent clinical notes, historical medical records, imaging reports, lab results). • Ensure the arrival of the packet at the specialist office and a timely patient appointment. • Work within the parameters of the patient insurance benefits and consult with benefit specialists as needed for the most high quality and cost effective care. • Troubleshoot downstream complications or unexpected circumstances so that patient needs are placed first and gaps in care are averted. • Assist in the development of technology and service innovations to ensure a closed loop system of communication and coordination with our Crossover providers and network specialists. • Perform other duties as assigned. Required Qualifications • At least 3 years of applicable experience (experience in a Primary Care setting preferred) • High school diploma/GED required • Proficient working with Google spreadsheets and/or excel, database management and data tracking • Access to a quiet / private remote work environment • High speed internet access • Willing and able to work on Thursdays and Fridays 8a-5p EST. Preferred Qualifications • Bachelor's Degree or relative medical experience • Experience processing referrals for a medical group • Creative and flexible and effectively manages obstacles • Excellent follow-through and have strong task execution skills
The base pay range for this position is $25.89 to $34 per hour. Pay range may vary depending on work location, applicable knowledge, skills, and experience. This position will be eligible for 401K.
Crossover Health is committed to Equal Employment Opportunity regardless of race, color, national origin, gender, sexual orientation, age, religion, veteran status, disability, history of disability or perceived disability. If you need assistance or an accommodation due to a disability, you may email us at careers@crossoverhealth.com.
To all recruitment agencies: We do not accept unsolicited agency resumes and are not responsible for any fees related to unsolicited resumes.
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