Virtual Care Advocate

As a Virtual Care Advocate, you are the front door to virtual care at Included Health, functioning much like the front desk of a medical office. You will be the first point of contact for members across phone and messaging channels, helping them navigate our app, answer healthcare questions, and connect them to the right services based on their Health Plan or Client package types.

The team supports multiple areas of the member experience and is expected to show up fully within the Tier 1 scope to deliver a seamless, member-first experience at every interaction. You will be responsible for resolving member needs at first touch whenever possible, gathering accurate information, and documenting clearly. When a situation requires escalation to another support team, you will identify the appropriate handoff flow, whether to Technical Support or downstream teams such as Virtual Care Support, Quality, Imaging, or Referrals teams.

Core responsibilities include account troubleshooting and scheduling support, eligibility and coverage troubleshooting, provider documentation, prescription, lab, imaging, and referral status inquiries.

Responsibilities:

• Serve as a first-contact support advocate for members across Virtual Care and Core interactions.
• Handle inbound calls, messaging, and standard support needs with accuracy, empathy, and urgency.
• Resolve routine virtual-care member issues end-to-end whenever they fall within Tier 1 General scope.
• Gather complete and relevant details to understand the member’s needs before determining next steps.
• Document interactions clearly, accurately, and completely in required systems.
• Use established SOPs, knowledge resources, workflow guidance, and approved job aids to support issue resolution.
• Use Care App, Athena, Hub, CXone, and other approved tools to complete trained workflows accurately.
• Create or update cases correctly for Tech support, Quality, VCS, imaging/referral, and medical-records-related workflows when required.
• Capture clear case descriptions, troubleshooting steps already taken, and the correct case type, subtype, and channel fields when escalation is needed.
• Reinforce a seamless member experience during handoffs by setting expectations clearly and minimizing friction.
• Flag recurring issues, workflow gaps, or member pain points to supervisors.
• Recommend ways the team can improve the member experience based on recurring support patterns.
• Acknowledge members’ rights on confidentiality issues, maintain member confidentiality at all times, and follow HIPAA guidelines and regulations.
• Maintain quality, productivity, attendance, and schedule adherence expectations.
• Participate in onboarding, training, calibration, and ongoing skill development.