Member Advocate & Care Coordination Specialist

American Health Communities; Lubbock (TX); On-site; USD 45,000 - 75,000; Full time

Job summary

American Health Advantage seeks a customer-service focused leader to support local service areas and ensure strong member advocacy. You will coordinate with Insurance Producers and act as the primary contact for enrolled members and their families to resolve plan questions and provide periodic plan updates.

As front-line support, you will work with member facilities and the care team to meet member needs, develop regional provider relationships, and maintain monthly member meetings while

Qualifications

• Experience in healthcare delivery with elderly patients.
• Excellent interpersonal and communication skills.
• Ability to work independently and in a team.
• CMS regulations compliance experience.
• Willingness to travel to facilities in the region.
• Nursing home experience preferred.
• Driver license is required.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure a seamless transition and accurate records.
• Follow up with members and families to answer questions and provide updates on the plan.
• Act as front-line support with the member, facility, and care team to meet member needs and CMS requirements.
• Develop and maintain relationships with key network providers/facilities within the region.
• Meet with the member and/or family at least monthly.
• Ensure that all interactions with the member are compliant with CMS regulations.
• Develop and maintain reporting on member status, facility calendars, and issues tracking.
• Oversee a group of nursing facilities to ensure service delivery for all members in the assigned group.
• Other responsibilities as assigned.

Skills

Interpersonal skills

Customer service

Written communication

Verbal communication

Active listening

Team collaboration

Organizational skills

Travel willingness

Education

Associates or better

Tools

MS Office

Job description

American Health Advantage seeks a customer-service focused leader to support local service areas and ensure strong member advocacy. You will coordinate with Insurance Producers and act as the primary contact for enrolled members and their families to resolve plan questions and provide periodic plan updates.

As front-line support, you will work with member facilities and the care team to meet member needs, develop regional provider relationships, and maintain monthly member meetings while