Member Experience & Care Advocate

American Health Partners; Odessa (TX); 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. You will coordinate with Insurance Producers after enrollment, ensure seamless transitions, and provide ongoing member support with the care team.

The role requires strong interpersonal and organizational skills, willingness to travel to facilities, and proficiency with Microsoft Office. Monthly member meetings and regulatory compliance are key responsibilities.

Qualifications

• Experience in a healthcare delivery setting with elderly patients; nursing home preferred.
• Exceptional interpersonal and listening skills with a team mindset.
• Ability to work with nursing staff, doctors and administration staff.
• Proven track record of outstanding customer service.
• Compliant with CMS regulations regarding Medicare Advantage Plans.
• Exceptional organizational skills and attention to detail.
• Strong written and verbal communication; ability to simplify complex issues.
• Willingness and ability to travel to facilities; valid driver’s license and insurance.
• Proficient in Microsoft Office; suitable home workspace.
• Insurance/customer service license preferred but not required.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure seamless transitions.
• Follow up with enrolled members to answer questions and provide updates.
• Serve as front-line support with members, partner facilities and care team.
• Develop and maintain relationships with network providers/facilities in the region.
• Meet with members and/or their families at least monthly.
• Follow up on dissatisfaction items and report to the plan.
• Develop and maintain reporting on member status and calendars.
• Ensure all member interactions comply with CMS regulations.
• Oversee services for a group of nursing facilities as the Member Advocate.
• Handle other responsibilities as assigned.

Skills

Interpersonal skills

Listening skills

Communication skills

Time management

Willingness to travel

Team collaboration

Customer service excellence

Problem solving

Attention to detail

Tools

Microsoft Office

Job description

American Health Advantage is seeking a customer-service focused leader to support local service areas. You will coordinate with Insurance Producers after enrollment, ensure seamless transitions, and provide ongoing member support with the care team.

The role requires strong interpersonal and organizational skills, willingness to travel to facilities, and proficiency with Microsoft Office. Monthly member meetings and regulatory compliance are key responsibilities.