Member Advocate & Nursing Facility Liaison

TruHealth; Fort Worth (TX); Hybrid; 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 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.