Member Advocate: Elder Care & Provider Liaison

American Health Communities; Carmel (IN); Hybrid; USD 52,000 - 72,000; Full time

Job summary

American Health Advantage seeks a customer-service focused leader to support local service areas and ensure enrollment and ongoing member support success.

The role involves coordinating with Insurance Producers, following up with members and their families, and acting as the primary contact for plan questions while maintaining CMS compliance and strong reporting for nursing facilities in the region.

Qualifications

• Experience in healthcare delivery with elderly patients (clinician, social worker or caregiver).
• Nursing home experience preferred.
• Excellent interpersonal and listening skills.
• Ability to work with nursing home staff, doctors and administration staff.
• Deliver outstanding customer service with CMS compliance knowledge.
• Strong organizational and written/verbal communication skills.
• Willingness to travel within the assigned region; valid driver’s license and insurance.
• Proficiency with Microsoft Office Suite.

Responsibilities

• Coordinate with Insurance Producer to ensure seamless enrollment and customer service success.
• Follow up with members to answer questions and provide plan updates.
• Act as frontline support with members, facilities and care team to meet needs.
• Develop and maintain relationships with regional providers and facilities.
• Meet with members or families at least monthly.
• Follow up on issues and report to plan accordingly.
• Develop and maintain reports on member status and facility calendars.
• Ensure all interactions comply with CMS regulations.
• Oversee services for a group of nursing facilities.

Skills

Healthcare experience

Customer service

Interpersonal skills

Communication skills

Organizational skills

Travel willingness

Education

Associates degree

Tools

Microsoft Office

Job description

American Health Advantage seeks a customer-service focused leader to support local service areas and ensure enrollment and ongoing member support success.

The role involves coordinating with Insurance Producers, following up with members and their families, and acting as the primary contact for plan questions while maintaining CMS compliance and strong reporting for nursing facilities in the region.