Provider / Member Advocate, West Virginia Senior Advantage

CommuniCare Health Services; Charleston (WV); Remote; USD 40,000 - 80,000; Full time

Job summary

An innovative health plan is seeking passionate Provider / Member Advocates to join their remote team. This role focuses on empowering members by assisting them in navigating their healthcare journey, ensuring they receive the right services at the right time. With a commitment to enhancing the member experience, you'll play a crucial role in personalizing advocacy approaches and coordinating essential support. This position offers a dynamic work environment with extensive travel opportunities, allowing you to make a meaningful impact in the lives of members across northern West Virginia. If you are driven, detail-oriented, and possess strong communication skills, this is the perfect opportunity for you.

Benefits

Life Insurance

LTD/STD

Medical, Dental, and Vision

401(k) Employer Match

Flexible Spending Accounts

Paid Time Off

Qualifications

• 2+ years in a similar role with strong communication and organizational skills.
• Advanced degree or equivalent experience in healthcare or social services.

Responsibilities

• Assist members with care navigation to enhance their healthcare experience.
• Coordinate services and support for members to access the right healthcare.

Skills

Communication Skills

Detail-oriented

Time Management

Computer Skills

Organizational Skills

Education

Four-year advanced degree or equivalent work experience

2+ years healthcare experience or educational equivalent

Tools

Microsoft Applications

Windows-based Applications

Job description

West Virginia Senior Advantage, a CommuniCare Medicare Advantage plan, is currently seeking Provider / Member Advocates for our health plan. This is a remote position involving 90% travel mostly to our facilities in northern West Virginia.

PURPOSE / BELIEF STATEMENT

Member Advocates are dedicated to assisting our members with care navigation and enrichment to maximize the member healthcare experience. Member Advocates will personalize their advocacy approach to each member by coordinating their services and support to get them to the right services, in the right place, at the right time. Member Advocates empower members in making healthcare decisions that are right for them and their families.

WHAT WE OFFER

Beyond our competitive wages and Paid Time Off, we offer all full-time employees a variety of benefit options including:

• Life Insurance
• LTD/STD
• Medical, Dental, and Vision
• 401(k) Employer Match with Flexible Spending Accounts

QUALIFICATIONS / EDUCATION REQUIREMENTS

Required:

• 2+ years working in a similar role
• Expert/Highly Skilled with computer skills: Windows-based applications and Microsoft applications
• Ability to travel throughout the designated local territory 90% of the work time.
• Advanced organizational and communication skills
• Four-year advanced degree or equivalent work experience in healthcare payors, social services field, advocacy, customer relations, or other related industry
• 2+ years healthcare experience or educational equivalent
• Skill in establishing priorities with independent coordination of day-to-day duties
• Function independently and responsibly with minimal need for supervision

Preferred Qualifications:

• Ability to develop and manage relationships
• Credentialing or Provider Relations experience
• Health plan experience
• Ability to manage multiple priorities
• Understanding of healthcare structures
• Understanding and experience with insurance and/or billing
• Experience in long term care
• Experience with medical terminology

JOB SKILLS:

• Must have strong oral and written communication skills.
• Must be detail-oriented with an ability to work well both independently and in a team setting.
• Strong time management skills required. Must be able to prioritize and adhere to competing deadlines.
• Must be proficient with computer skills and Microsoft applications.

Qualified candidates, apply now for a chance to join our outstanding team!