Member Advocate & Care Liaison

American Health Plans; St. Louis (MO); On-site; USD 52,000 - 70,000; Full time

Job summary

American Health Plans is seeking a Member Advocate to lead customer-service focused outreach for local service areas in Missouri. You will coordinate with care teams, engage with nursing facilities, and maintain essential relationships to ensure plan needs are met.

The role requires traveling within the region, ensuring CMS compliance, and providing periodic updates to members and families. Strong communication and organizational skills are essential.

Qualifications

• Requires experience in healthcare delivery with elderly patients (clinical/social work/caregiving preferred).
• Excellent interpersonal and listening skills in a team setting.
• Ability to collaborate with nursing homes, doctors, and administrative staff.
• Strong compliance with CMS regulations and documentation practices.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure smooth transitions.
• Follow up with members and families to answer questions and provide updates.
• Serve as frontline liaison with members, facilities, and care teams to meet needs.
• Develop and maintain relationships with regional providers and facilities.
• Meet with members and families at least monthly to review plans and concerns.
• Report and manage member dissatisfaction and CMS compliance issues.
• Maintain reporting on member status, facility calendars, and issue tracking.

Skills

Interpersonal skills

Communication skills

Organizational skills

Active listening

Travel readiness

Education

Associate degree

Tools

Microsoft Office

Job description

American Health Plans is seeking a Member Advocate to lead customer-service focused outreach for local service areas in Missouri. You will coordinate with care teams, engage with nursing facilities, and maintain essential relationships to ensure plan needs are met.

The role requires traveling within the region, ensuring CMS compliance, and providing periodic updates to members and families. Strong communication and organizational skills are essential.