Activities Director

American Health Partners; Erie (Erie County); Remote; USD 42,000 - 64,000; Full time

Benefits offered by this job

Travel reimbursement

Flexible schedule

Remote work

Job summary

American Health Plans seeks a dedicated Member Advocate to support local service areas. This role involves remote work with regular travel to nursing homes within a defined region, ensuring member needs are met and CMS guidelines are followed.

Key duties include welcoming members, monthly outreach, building provider relationships, documenting activities, and coordinating visits with care teams. Associate degree preferred and strong customer service skills are essential.

Qualifications

• Associate degree preferred or equivalent experience.
• Healthcare delivery setting experience with elderly patients preferred.
• Driver license required and reliable transportation.
• Willingness to travel within the assigned region.

Responsibilities

• Welcome new members following Plan processes.
• Visit or contact members at least monthly.
• Develop and maintain relationships with regional network providers and nursing facilities.
• Sponsor or assist at least one group activity annually at each facility.
• Coordinate facility visits to ensure coverage and CMS compliance.
• Document all activities as required.

Skills

Interpersonal skills

Customer service

Travel

Independence

Organization

Transportation

CMS compliance

Education

Associate's degree preferred

Tools

Microsoft Office

Job description

American Health Plans- Erie, PA
Erie, PA, USA

Description

JOB SUMMARY:
The Member Advocate is a customer-service focused position that will support local service areas. The position requires reasonable work-from-home space as no formal office space/work location is provided; however, the Member Advocate will conduct their work at partner nursing homes within a specific work region.

ESSENTIAL JOB DUTIES:

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.

• Welcome all new members in accordance with established Plan processes
• Visit or contact assigned members at least monthly
• Develop and maintain relationships with key network providers, nursing home staff, and facilities within assigned region
• Annually sponsor or assist a minimum of one group activity at each regional nursing facilities
• Contact TruHealth staff or appointees at least monthly, but more often as appropriate, to discuss and ensure the needs of the Member and Plan are met; coordinate facility visits within the team to ensure necessary coverage for the facility
• Document all activities as required
• Follow up on any item(s) members are dissatisfied with and report to Plan accordingly
• Ensure all interactions with the members are compliant with CMS regulations
• Attend meetings as necessary
• Other responsibilities as assigned

JOB REQUIREMENTS:

• Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team; must be a good listener to understand feedback from the family
• Ability to work well with staff at each of the nursing homes in the assigned region to include nursing staff, doctors, and administration staff
• Ability to deliver outstanding customer service with a proven track record
• Exceptional organizational skills
• Willingness and ability to travel to facilities within assigned region
• Have suitable home workspace allowing for productive office environment
• Compliant with CMS regulations regarding Medicare Advantage Plans
• Successfully complete required training
• Handle multiple priorities effectively
• Independent discretion
• Reliable transportation
• Possess clean driving record and current automobile insurance according to company policy
• Maintain regular and reliable attendance
• Successfully complete required training
• Handle multiple priorities effectively

Required Computer Software/Equipment Used:

• Various operating systems
• Standard office equipment
• Microsoft Suite applications

QUALIFICATIONS:

• Education: Associate’s degree preferred
• Experience: Experience in a healthcare delivery setting with elderly patients as either a clinician, social worker or caregiver preferred
• License /Education: Associate’s degree preferred
• State driver’s license

COMPANY COMPETENCIES:

• Respect – We treat people as they want to be treated, showing regard for their rights and privacy
• Integrity – We emphasize honesty, fairness, and doing the right thing even when no one is watching
• Teamwork – We work collaboratively to improve processes, resolve problems and reward results
• Excellence – We hold ourselves to the highest standards, aspiring to zero defects in every task
• Compassion – We respond to those who need help with sensitivity and a positive attitude
• Professionalism – We perform our duties with skill, good judgement and politeness

JOB COMPETENCIES:

1. Analytical Thinking: Able to gather and analyze data and reach appropriate conclusions; solves problems in a timely manner.
2. Customer and Personal Service: Possess good interpersonal skills while dealing with emotional or difficult situations; respond promptly to customer’s needs. Knowledge of principles and processes for providing personal services, including needs assessment; meeting quality standards.
3. Accountability: Accepts responsibility for own decisions, actions, and results; able to maintain dependable behavior in times of crisis or complexity.
4. Attendance: Is consistently at work and on time; ensures work responsibilities are covered; returns from lunch and breaks appropriately; arrives at meetings on time; notifies supervisor of pending absences.
5. Communication: Speaks and writes clearly and persuasively; listens and receives clarification.
6. Ethical Behavior: Upholds organizational values and abides by state and federal regulations; maintains confidentiality of HIPAA information; treats others with respect.
7. Initiative: Seeks increased responsibility; sets self-improvement goals related to the organization’s objectives.
8. Job and Industry Knowledge: Demonstrates knowledge of the position and industry; seeks additional information.
9. Productivity and Quality of Work: Maintains high level of performance while demonstrating commitment to accuracy and thoroughness.
10. Teamwork: Displays ease working with others; contributes ideas and skills to team; puts success of team above own interests. Communicates with co-workers at all levels to adequately meet the needs of members.

SCOPE AND LEVEL OF WORK:

• Complexity: assignment is performed within an established framework under general instructions but requires simultaneous coordination of assigned functions or projects in various stages of completion.
• Decision Making: Exercises judgment and discretion.
• Communications: Contacts with the public or employees where explanatory or interpretive information is exchanged, defended, and gathered and discretion and judgment are required within the parameters of the job function.
• Supervision Received: Performs work with supervisory oversight. Under general supervision, receives assignments and is expected to carry them through to completion with substantial independence. Work is reviewed for adherence to instructions, accuracy, completeness, and conformance to standard practice or precedent. Recurring work clearly covered by guidelines may or may not be reviewed.
• Social Interaction: Interpersonal contacts with individuals within or outside the organization may occasionally result in unexpected demands, requiring restructuring of priorities, and the performance of several related tasks simultaneously.
• Impact of Actions: An error in action may affect more than one work department in the organization. Errors have the potential to cause avoidable costs and inconveniences.

SUPERVISORY RESPONSIBILITIES:

• Does not have supervisory responsibilities
• Occasionally needs manager’s direction due to extraordinary circumstances

WORKING CONDITIONS:

• Audio-Visual: Hearing: Good
• Ability to lift to 10 pounds
• Subject to standing, walking, sitting
• Position may require flexible hours, unscheduled overtime or occasional week-end work
• Must be able to speak and write in English
• Daily Travel required

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SAFETY EXPECTATIONS:

• Work safely and follow safety rules
• Report unsafe working conditions and behaviors
• Take reasonable and prudent actions to prevent others from engaging in unsafe practices

EQUAL OPPORTUNITY EMPLOYER

This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.

Qualifications

Education

Preferred

Associates or better.

Licenses & Certifications

Required

Driver License

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.