Activities Director

TruHealth; Fort Worth (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

American Health Plans in Fort Worth, TX is seeking a Member Advocate to provide customer-service oriented support across local service areas. The role involves a flexible work-from-home setup with duties performed at partner nursing homes in the region.

The role requires visiting members monthly, building relationships with nursing home staff and providers, and sponsoring group activities. It also includes documenting activities and ensuring CMS compliance.

Qualifications

• Exceptional interpersonal skills; able to work independently or in a team.
• Ability to travel to facilities within the assigned region.
• Deliver outstanding customer service with a proven track record.
• Strong organizational abilities.
• Willingness and ability to travel to facilities within assigned region.
• Compliant with CMS regulations for Medicare Advantage.

Responsibilities

• 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 facility.
• Coordinate facility visits with the team to ensure necessary coverage.
• Document all activities as required.
• Follow up on items members are dissatisfied with and report to Plan accordingly.
• Ensure all interactions comply with CMS regulations.
• Attend meetings as necessary.
• Other responsibilities as assigned.

Skills

Interpersonal skills

Customer service

Organizational skills

Independent work

Travel willingness

CMS regulations knowledge

Job description

American Health Plans
Fort Worth, TX, 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: