Member Advocate: Patient Support & Regional Network Lead

American Health Partners; Ashland (KY); Hybrid; USD 42,000 - 64,000; Full time

Job summary

American Health Advantage seeks a customer-service focused leader to support local service areas and ensure seamless enrollment-to-service transitions.

The role involves coordinating with insurers, following up with members and families, and serving as a frontline liaison among members, facilities, and care teams. Travel to facilities in the region is expected to maintain strong provider networks and service quality.

Qualifications

• Experience in healthcare delivery settings, especially with elderly patients (clinical, social work, or caregiver roles).
• Nursing home experience preferred but not required.
• Exceptional interpersonal and communication skills with the ability to listen and respond to families.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure smooth transitions.
• Follow up with members and families to answer questions and provide plan updates.
• Serve as front-line support with members, partner facilities and care team to meet member and plan needs.
• Build and maintain relationships with network providers/facilities in the region to support network adequacy.
• Meet with members or families at least monthly.
• Escalate and report any member dissatisfaction and track issues.
• Maintain reporting on member status and facilities calendars; monitor issues.
• Ensure all member interactions comply with CMS regulations.
• Oversee services for a group of nursing facilities within assigned region; ensure consistent service delivery.
• Perform additional duties as assigned.

Skills

Interpersonal skills

Customer service

Written and verbal communication

Organizational skills

Analytical thinking

Willingness to travel

Job description

American Health Advantage seeks a customer-service focused leader to support local service areas and ensure seamless enrollment-to-service transitions.

The role involves coordinating with insurers, following up with members and families, and serving as a frontline liaison among members, facilities, and care teams. Travel to facilities in the region is expected to maintain strong provider networks and service quality.