Member Advocate: Patient Care & Network Liaison

American Health Communities; St. Louis (MO); On-site; USD 55,000 - 75,000; Full time

Job summary

American Health Advantage seeks a customer-service focused leader to support local service areas. The role coordinates with Insurance Producers and care teams to ensure seamless enrollment transitions and ongoing member support, while maintaining CMS-compliant interactions.

You will build and sustain relationships with network facilities, meet with families monthly, and travel as needed within the region to ensure plan success.

Qualifications

• Experience in a healthcare delivery setting with elderly patients or caregivers.
• Ability to navigate CMS regulations and Medicare Advantage Plans.
• Strong organizational skills and ability to manage multiple facilities.
• Proven customer service excellence with clear communication.
• Willingness to travel within the assigned region with valid license and insurance.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure seamless transitions.
• Follow up with members to answer questions and provide plan assistance.
• Provide front-line support with members, facilities, and care teams.
• Develop and maintain relationships with network providers within the region.
• Meet with members or families monthly to review needs.
• Address member dissatisfaction and report findings to the plan.
• Maintain reporting on member status, calendars, and issue tracking.
• Ensure all interactions comply with CMS regulations.
• Oversee services for a group of nursing facilities within the assigned region.
• Perform other duties as assigned.

Skills

Interpersonal Skills

Customer Service

Communication

Travel Readiness

Team Collaboration

Education

Associates

Tools

Microsoft Office Suite

Job description

American Health Advantage seeks a customer-service focused leader to support local service areas. The role coordinates with Insurance Producers and care teams to ensure seamless enrollment transitions and ongoing member support, while maintaining CMS-compliant interactions.

You will build and sustain relationships with network facilities, meet with families monthly, and travel as needed within the region to ensure plan success.