Firefly Health is building a revolutionary new type of comprehensive health "care and coverage,” powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and our proprietary technology platform.

Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver clinical and financial health through joyful, always there care. We are flipping the script on what it means to be a health plan and actually providing a true health benefit to members.

We are intensely focused on optimizing the physical + mental + financial wellbeing of those who want (and deserve) something better than the status quo. If you are ready to roll up your sleeves and take on our audacious mission, we would love to hear from you.

The Role

As a Care Guide at Firefly Health, you'll be a vital member of our integrated care team, providing comprehensive care support services to our members. You'll manage a wide range of tasks, ensuring seamless patient journeys and providing essential operational support that empowers our clinicians. This is a dynamic role for individuals passionate about healthcare and dedicated to supporting patient well-being in an innovative, virtual-first environment.

You will:

Patient Connections

• In-App Patient Chat Management: Efficiently manage in-app patient communication, providing effective responses to inquiries and escalating complex issues to the appropriate Care team members.
• Proactive Member Outreach: Initiate proactive outreach to members via chat to encourage their active participation in important health screenings and preventive care programs.
• Patient Education & Guidance: Provide patients with clear instructions for follow-up care, medication usage, and health education materials as directed by clinicians.

Integrated Care Support

• Medication Prior Authorizations: Manage medication prior authorizations, submitting them for insurance approval to ensure seamless access to necessary prescriptions.

• Quality & Population Health: proactively review medical records and referral notes to identify pertinent quality and care information, engage patient care teams to ensure timely placement of overdue preventative screenings, and take initiative to identify care gaps and coordinate follow-up.
• Patient Journey Coordination: Schedule patient appointments, coordinate follow-up care, and facilitate the collection of patient vitals, either through self-collection or by retrieving data from external records.
• Form Management & Visit Preparation: Collect and prepare essential patient forms, ensuring they are ready for review and action by the Care team.
• Emergency Care Monitoring: Monitor and promptly notify the Care team of patient emergency and inpatient visits to facilitate timely outreach and follow-up.
• Clinical Support Tasks: Perform additional clinical support tasks as required to ensure comprehensive patient care and team efficiency.

Administrative Care Services

• Fax Management: Efficiently review and file all incoming faxes, ensuring strict adherence to HIPAA guidelines and established clinical workflows.
• Medical Record Retrieval: Proactively retrieve prior medical records and referral records essential for comprehensive patient care.
• Performance Metrics & Adaptability: Meets defined expectations and compliance for outreach volume, chat responsiveness, and follow-up accuracy, and performs other duties as assigned to support team needs.

You’d be a good fit if:

• At least 1 year of experience in a healthcare support, administrative, or customer service role, ideally in a fast-paced virtual care delivery environment or a direct patient care setting.
• Exceptional written and verbal communication skills.
• Proficiency and comfort with new technologies and digital systems.
• Strong organizational abilities and meticulous attention to detail.
• Ability to effectively manage multiple tasks and priorities.
• A proactive mindset for identifying and resolving issues.
• A deep commitment to patient satisfaction.
• High adaptability and the ability to thrive amidst frequent change in a dynamic work setting.
• A solid understanding of and unwavering commitment to HIPAA compliance and patient privacy.

Schedule: Care Guides work 5 days per week, 8-hour shifts, within our current coverage hours of Monday to Friday, 7 am to 7 pm EST.

The salary range for this position is $25 per hour to $28 per hour; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Firefly Health is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

Our office is in Watertown, Massachusetts, but we’ve developed a robust remote working structure to give us more geographical flexibility while hiring for many positions. This role can be done largely remotely, there are several times a year when staff come together onsite for planning and team building.

Firefly is an equal opportunity employer. We value diverse backgrounds and perspectives. We're committed to building and sustaining an inclusive workplace culture where individuals are treated with dignity and respect. All employment is decided on the basis of qualifications, merit, and business need. Firefly is an E-Verify employer.