Regional Member Advocate

American Health Communities; Springfield (MO); 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, ensure seamless transitions after enrollment, and act as the primary contact for members and families.

You will build relationships with network providers, travel within the region, ensure CMS compliance, and maintain calendars and reports. The role requires independent work, strong communication, and a commitment to high-quality member experience.

Qualifications

• Experience in healthcare delivery with elderly patients.
• Excellent interpersonal and listening skills.
• Ability to work independently and in a team.
• Ability to interact with nursing home staff and physicians.
• Commitment to CMS regulations and Medicare/MA requirements.
• Strong organizational and communication skills.
• Willingness to travel within the region with reliable transportation.
• Proficiency with Microsoft Office.
• Home workspace suitable for a productive environment.
• Insurance license preferred but not required.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure seamless transition.
• Follow up with members to answer questions and provide updates.
• Serve as frontline support for members, facilities, and care team.
• Develop and maintain relationships with regional network providers/facilities.
• Meet with members and/or families at least monthly.
• Report member dissatisfaction to plan and track issues.
• Maintain reporting on member status and facility calendars.
• Ensure all interactions comply with CMS regulations.
• The Member Advocate oversees a group of nursing facilities and services for each facility.
• Perform other duties as assigned.

Skills

Healthcare delivery experience

Interpersonal skills

Customer service excellence

CMS regulations compliance

Organizational skills

Communication skills

Travel willingness

Microsoft Office proficiency

Home office setup

Insurance license (preferred)

Education

Associates

Job description

American Health Advantage is seeking a customer-service focused leader to support local service areas. You will coordinate with Insurance Producers, ensure seamless transitions after enrollment, and act as the primary contact for members and families.

You will build relationships with network providers, travel within the region, ensure CMS compliance, and maintain calendars and reports. The role requires independent work, strong communication, and a commitment to high-quality member experience.