What is care navigation and why is it important?

Employers invest millions of dollars in healthcare benefits, yet rising costs, growing HR burdens, and low employee engagement continue to undermine plan performance. Benefits teams spend countless hours answering “Which doctor can I see?” or “Is this covered in my plan?”—but the deeper issue is clear: employees rarely engage meaningfully with their plans. In fact, 67% spend 30 minutes or less reviewing options during open enrollment, and nearly 40% don’t know where to find reliable benefits information.

Care navigation solves these pain points by giving every employee one clear entry point that guides them to high-quality, lower-cost care, clearly explains coverage, and surfaces real-time prices before decisions are made. This “single front door” cuts wasteful spending, lifts utilization of the benefits you’re already paying for, and allows HR to focus on strategy instead of playing help desk. 

What is care navigation?

Care navigation is a benefit that connects employees to the right care, improves outcomes, and reduces employer healthcare costs. Employees often struggle to understand what their health plan covers, which provider to see, or how much a procedure will cost. Care navigation acts as a personal guide through an otherwise fragmented and opaque healthcare system, transforming a confusing, expensive ecosystem into a guided, seamless experience. Its purpose is to give patients one trusted “front door” to:

Personalized clinical guidance.

Healthcare navigators explain treatment pathways and tailor recommendations to each member’s medical history and preferences, so care decisions feel confident, not like guesswork. Healthcare navigators provide guidance on symptoms and treatment options and offer clinical navigation for high-risk members. Clinical health guides who are nurse practitioners, registered nurses, and licensed social workers deliver real-time clinical insight and help employees make the best care decisions.

Benefits education.

With care navigation, members have access to one-on-one support to break down plan details, highlight programs, and coach them on when and how and when to use each benefit. 

Provider matching.

Based on specialty, availability, and personal preferences, members are connected to high-value providers that fit their specific needs and schedule. This guidance adds a layer of assurance that members receive the high-value care they need.

Integrated telemedicine.

Members can chat or video-visit with clinicians 24/7 for primary-care concerns, ensuring quick triage and continuity with the broader navigation experience. Rightway partners with Curai for on-demand virtual care, providing employees with convenient, cost-effective, and high-quality care. 

Cost transparency and financial guidance.

Care navigation teams help members by surfacing real-time price estimates, helping them understand their bills, and resolving billing issues on their behalf.

What are the benefits of care navigation?

Care navigation delivers a double win: It gives members a guided, stress-free path through a confusing health system while helping employers reduce spending and lighten HR workloads. By pairing personalized clinical guidance with real-time cost transparency and seamless benefit education, navigation improves health outcomes, boosts benefit engagement, and lowers healthcare costs, all from a single “front door.” 

Member benefits.

• One trusted guide. 24/7 clinician access and curated provider matches.

• Simplified decisions. Clear explanations of coverage and treatment options help members choose the right care the first time. 

• Faster, cheaper care. Integrated telemedicine and upfront price estimates shorten time to treatment and eliminate surprise bills.

Organizational benefits.

• Lower total spend. Steering members to high-value care sites and lower-cost medications cuts medical and pharmacy costs. Higher benefit engagement. A single entry point drives consistent program use, raising overall ROI. 

• Reduced HR burden. Routine “which doctor?” or billing questions shift to navigators, freeing HR to focus on strategic initiatives. 

Choosing the right healthcare navigation partner.

When you evaluate a care navigation partner, look for three essentials: human expertise, clinically supported, and proven financial impact. Best-in-class vendors pair clinical navigators with an intuitive app that makes it effortless for members to chat, book visits, or compare prices in seconds. Rightway care navigation solution brings all of these must-haves together. Members get concierge-level personalized support from a dedicated team that knows their history and preferences, while the Rightway app serves as a single entry point to benefits, claims, and real-time cost estimates. 

Shift from reactive to proactive healthcare with care navigation—improving employee well-being, reducing costs, and driving better outcomes.

Ready to learn how Rightway’s Care Navigation can simplify care and cut costs? Schedule a demo to see the platform in action here.