Member Experience Navigator

American Health Partners; Seymour (IN); On-site; USD 55,000 - 75,000; Full time

Job summary

American Health Advantage seeks a customer-service oriented leader to support local service areas and ensure seamless transitions after enrollment. You will act as a point of contact for members and families, providing updates and facilitating plan-related support.

The role requires coordinating with facilities and care teams, developing regional provider relationships, monthly member meetings, and strict CMS compliance across all activities.

Qualifications

• Experience in healthcare delivery with elderly patients (clinical, social work or caregiver).
• Excellent interpersonal and communication skills.
• Ability to work independently and in teams; strong listening.
• Willingness to travel to facilities; valid driver's license and insurance.
• Proficiency with Microsoft Office Suite.
• Familiarity with CMS regulations, Medicare Advantage.

Responsibilities

• Coordinate with Insurance Producer after enrollment for a smooth transition.
• Follow up with members and families to answer questions and provide plan updates.
• Provide frontline support for members, facilities, and care teams.
• Develop relationships with network providers and facilities in the region.
• Meet with members or families monthly.
• Report issues and maintain member status and schedules.
• Ensure all interactions comply with CMS regulations.
• Oversee services for a group of nursing facilities.
• Handle other assigned responsibilities.

Skills

Interpersonal skills

Customer service

CMS compliance

MS Office proficiency

Travel willingness

Valid driver’s license

Education

Healthcare background in elderly care

Tools

Microsoft Office

Job description

American Health Advantage seeks a customer-service oriented leader to support local service areas and ensure seamless transitions after enrollment. You will act as a point of contact for members and families, providing updates and facilitating plan-related support.

The role requires coordinating with facilities and care teams, developing regional provider relationships, monthly member meetings, and strict CMS compliance across all activities.