Member Advocate: Senior Care & Care Coordination

American Health Communities; Bloomington (IN); On-site; USD 50,000 - 75,000; Full time

Job summary

American Health Plans in Bloomington, IN is seeking a Member Advocate to support local service areas. You will coordinate with the Insurance Producer to ensure a smooth enrollment-to-service transition and act as a dedicated contact for members and families.

You will engage with nursing facilities and care teams, maintain regional provider networks, and meet with members monthly. Strong CMS compliance and excellent communication are essential.

Qualifications

• Experience in healthcare delivery with elderly patients (clinician, social worker, or caregiver).
• Excellent interpersonal and listening skills; ability to work independently or in a team.
• Ability to coordinate with nursing homes, doctors and admin staff in the region.
• Proven track record of delivering outstanding customer service.
• Compliance with CMS regulations for Medicare Advantage plans.

Responsibilities

• Coordinate with Insurance Producer to ensure seamless enrollment to customer service handoff.
• Follow up with members and family to answer questions and provide plan updates.
• Serve as front-line contact with members, facilities, and care teams to meet needs.
• Build and maintain relationships with network providers/facilities in assigned region.
• Meet with members/families monthly and track issues and calendar activities.
• Ensure compliance in all member interactions and reporting.

Skills

Interpersonal skills

Customer service

CMS compliance

Verbal/written communication

Team collaboration

Travel readiness

Microsoft Office

Organizational skills

Driver's license

Education

Associates degree

Tools

Microsoft Office Suite

Job description

American Health Plans in Bloomington, IN is seeking a Member Advocate to support local service areas. You will coordinate with the Insurance Producer to ensure a smooth enrollment-to-service transition and act as a dedicated contact for members and families.

You will engage with nursing facilities and care teams, maintain regional provider networks, and meet with members monthly. Strong CMS compliance and excellent communication are essential.