Member Experience Advocate

American Health Partners; New Orleans (LA); On-site; USD 55,000 - 75,000; Full time

Job summary

American Health Advantage is seeking a customer-service focused leader to support local service areas and ensure member satisfaction with plan benefits. The role coordinates with Insurance Producers after enrollment, follows up with members, and acts as a primary contact for families needing plan information or assistance.

Strong communication and travel to facilities are expected. You will work with nursing facilities and providers, maintain relationships, and ensure CMS compliance across

Qualifications

• Experience in healthcare delivery with elderly patients (clinician, social work, or caregiver).
• Nursing home experience preferred.
• Strong interpersonal and teamwork skills; good listener.
• Excellent customer service track record.
• CMS regulations compliance experience is preferred.
• Excellent organizational, written, and verbal communication skills.
• Willingness to travel to facilities; valid driver's license and insurance.
• Proficient with Microsoft Office Suite.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure seamless transition and customer service success.
• Follow up with members after enrollment to answer questions and provide plan assistance to the member or family.
• Serve as front-line support with members, partner facilities, and care teams to meet member and plan needs.
• Develop and maintain relationships with network providers/facilities to meet network adequacy requirements.
• Meet with members or family at least monthly.
• Follow up on items that members are dissatisfied with and report to the plan.
• Develop and maintain reporting on member status, facility calendars, and issues tracking.
• Ensure all member interactions comply with CMS regulations.
• Oversee services for a group of nursing facilities and ensure above services are carried out for all members in your facilities.
• Other responsibilities as assigned.

Job description

American Health Advantage is seeking a customer-service focused leader to support local service areas and ensure member satisfaction with plan benefits. The role coordinates with Insurance Producers after enrollment, follows up with members, and acts as a primary contact for families needing plan information or assistance.

Strong communication and travel to facilities are expected. You will work with nursing facilities and providers, maintain relationships, and ensure CMS compliance across