Senior Care Navigator

About us Pomelo Care is the national leader in evidence-based healthcare for women and children. We deliver personalized, high-quality clinical interventions from reproductive care and pregnancy, infant care and pediatrics, to hormonal health through perimenopause and menopause, with long-term preventive care and condition management. Our model delivers 24/7 multispecialty care to address the medical, behavioral, and social factors that most significantly impact outcomes for women and children. We partner with payers, employers, and providers to expand access to quality healthcare across the system. Key responsibilities of the role Your North Star : You are the trusted first point of contact for our members. Through every interaction, you deliver clinically accurate, empathetic, and efficient support, ensuring members feel guided, heard, and cared for throughout their journey with Pomelo.You will manage the lifecycle of patient communication and navigation, ensuring no detail is overlooked as our members move through their care journey. Reporting to the Clinical Director, New Ventures, your key responsibilities will include: Member Communication: Act as the initial human touchpoint for patients, managing a high volume of inbound outbound messages via email and chat. Topics may include scheduling, billing, insurance coverage, prescription logistics, and general care navigation (e.g., next steps in care). Clinical Operational Support: Coordinate essential care logistics, including verifying medical and prescription eligibility, assisting with specialist referrals, and initiating prior authorizations. Issue Resolution: As necessary, triage properly escalate member concerns using established protocols (e.g., complex billing questions to Revenue Cycle team, medical questions to Clinical team). System Management: Maintain documentation within Zendesk and our Electronic Health Record (EHR) to ensure a source of truth across teams. Continuous Improvement: Partner cross-functionally to identify friction points in the patient experience. Propose and implement improvements to workflows, tools, and member-facing processes. Who you are 3+ years of experience in high-touch, patient-facing environments. Proficient in Zendesk (or similar ticketing tools) and Athena (or comparable EHR systems) Exceptional written and verbal communication skills, with the ability to translate complex healthcare information into clear, empathetic guidance. Proven judgment in handling sensitive issues, escalations, and time-sensitive care needs. Organized, detail-oriented, and energized by managing multiple workflows in a fast-paced environment Why you should join our team By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. And you'll learn, grow, be challenged, and have fun with your team while doing it. We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first. We also offer: Competitive healthcare benefits Generous equity compensation Generous vacation policy At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status. Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, Californi ... (truncated, view full listing at source)