Remote Customer Care Navigator – Autism & ABA Services Specialist Supporting Families Across PA, NJ, DE

About brighthush

brighthush is a leading health insurer dedicated to transforming the lives of individuals and families across the southeastern United States. With a legacy that dates back to 1938, brighthush has grown into a trusted partner for millions of members, offering comprehensive health plans, innovative care solutions, and a steadfast commitment to community well‑being. Our mission is simple: to empower people to live healthier, happier lives through accessible, high‑quality care.

At brighthush, we believe that every member deserves personalized support and that the best outcomes arise from collaboration between families, providers, and our dedicated care teams. As part of this vision, we are expanding our Autism Case Management program and are looking for a passionate, customer‑centric professional to join us as a Remote Customer Care Navigator. This role is pivotal in bridging families with the resources, benefits, and expertise they need to thrive.

Role Overview

As a Remote Customer Care Navigator, you will serve as the primary point of contact for families of children receiving Autism Spectrum Disorder (ASD) services. You will coordinate referrals, facilitate benefit authorizations, and guide families through the complex landscape of ABA therapy, diagnostic evaluations, and community resources. Your work will directly impact the quality of care and the overall experience of our members, ensuring they receive timely, accurate, and compassionate support.

Key Responsibilities

• Member & Provider Engagement: Respond to inbound calls from members and providers, delivering clear, concise information about autism, ABA, and related mental health benefits, as well as care management policies.
• Outreach & Education: Conduct proactive outreach to member families, educating them about the Autism Case Management program, screening for care needs, and collecting essential documentation.
• Referral Coordination: Collaborate with network providers to identify and secure appropriate referrals for diagnostics, ABA therapy, and specialty care.
• Authorization Support: Provide follow‑up calls and documentation to streamline the authorization process, ensuring timely access to services.
• Team Collaboration: Work closely with lead Autism Care Managers, attending rounds and team meetings to address member needs and coordinate care plans.
• Quality & Transition Management: Promote high‑quality service delivery and effective care transitions, aiming to optimize health outcomes and reduce family burden.
• Provider Access Facilitation: Coordinate with Network Operations staff to secure provider access within the member’s geographic area.
• Administrative Excellence: Manage manual communications (letters, faxes) and maintain accurate case files to support utilization management and coordinated care.
• Continuous Improvement: Identify opportunities to enhance service delivery, streamline processes, and improve member satisfaction.

Essential Qualifications

• Bachelor’s degree in Social Work, Psychology, Nursing, or a related healthcare field.
• Minimum of three (3) years of experience in a healthcare or managed‑care setting, with a strong focus on behavioral health or developmental disabilities.
• Proficient computer skills, including MS Outlook, Word, Excel, Adobe Acrobat, and data processing tools.
• Exceptional written and verbal communication, interpersonal, and organizational abilities.
• Strong assessment and engagement skills, with the capacity to build rapport quickly and empathetically.
• Basic understanding of diagnostic requirements and medical comorbidities related to ASD.
• Ability to make referrals for testing and coordinate with diagnostic providers.
• Self‑motivated, collaborative mindset, capable of working independently while meeting team objectives.
• Professional demeanor in all interactions, regardless of circumstances.
• Capacity to manage multiple tasks in a fast‑paced, evolving environment.

Preferred Qualifications

• Five (5) or more years of experience in a healthcare or managed‑care setting, with demonstrated success in autism or developmental disability care.
• Experience working directly with members who have autism or other developmental disabilities and their families.
• Bilingual proficiency in English and Spanish, enhancing communication with a diverse member base.
• Knowledge of behavioral health and medical terminology, facilitating clear and accurate documentation.
• Experience with utilization management processes and case building in electronic health record systems.

Skills & Competencies

• Customer‑first mindset: Passionate about delivering exceptional service and support.
• Problem‑solving: Ability to navigate complex benefit structures and find solutions quickly.
• Attention to detail: Accurate documentation and meticulous record‑keeping.
• Time management: Prioritize tasks effectively in a dynamic environment.
• Team collaboration: Work seamlessly with care managers, providers, and operations staff.
• Adaptability: Thrive in a remote setting while maintaining high productivity and engagement.

Career Growth & Learning Opportunities

At brighthush, we invest in your professional development. As a Customer Care Navigator, you will have access to:

• Structured onboarding and mentorship programs to accelerate your integration into the team.
• Regular training sessions on the latest autism care protocols, benefit policies, and technology tools.
• Opportunities to advance into senior navigator roles, care manager positions, or specialty program leadership.
• Cross‑functional projects that broaden your skill set and expose you to different areas of the organization.
• Access to industry conferences, webinars, and continuing education resources.

Work Environment & Culture at brighthush

Our culture is built on collaboration, innovation, and a genuine commitment to member well‑being. Even though this role is fully remote, you will be part of a vibrant, supportive team that values:

• Open communication: Regular virtual huddles, team meetings, and one‑on‑one check‑ins.
• Work‑life balance: Flexible scheduling and a focus on results rather than hours.
• Diversity & inclusion: A workforce that reflects the communities we serve, with inclusive policies and practices.
• Recognition: Celebrating achievements through awards, shout‑outs, and career milestones.
• Community impact: Opportunities to contribute to local initiatives, volunteer programs, and advocacy efforts.

Compensation & Benefits

While specific salary ranges are determined by experience and qualifications, brighthush offers a competitive compensation package that includes:

• Competitive base salary aligned with industry standards.
• Performance‑based bonuses and incentive programs.
• Comprehensive health benefits: Medical, dental, vision, and mental‑health coverage.
• Retirement savings plan with employer match.
• Paid time off, holidays, and flexible leave policies.
• Professional development stipend and tuition reimbursement.
• Well‑being resources: Employee assistance program, wellness challenges, and mindfulness tools.
• Technology stipend for remote work setup and home‑office equipment.

How to Apply

If you are a dedicated, compassionate professional eager to make a tangible difference in the lives of families navigating autism care, we encourage you to apply. Submit your resume and a brief cover letter outlining your experience with autism or developmental disability services and why you are excited about this role at brighthush.

Join us in our mission to provide exceptional, personalized care to every member. Your expertise will help families access the resources they need, fostering healthier, happier communities across Pennsylvania, New Jersey, and Delaware.

Ready to take the next step? and become a vital part of the brighthush family.