Regional Member Advocate & Care Coordinator

American Health Partners; Jackson (MS); On-site; USD 42,000 - 68,000; Full time

Job summary

American Health Advantage is seeking a customer-service focused leader to support local service areas as a Member Advocate. You will coordinate with Insurance Producers after enrollment, follow up with members, and serve as a front-line contact for members and care teams.

Responsibilities include maintaining provider relationships, monthly member meetings, and robust reporting while ensuring CMS compliance across facilities in your region.

Qualifications

• Experience in a healthcare delivery setting with elderly patients preferred.
• Exceptional interpersonal and communication skills with the ability to work independently and with a team.
• Ability to travel to facilities within the assigned region and maintain a valid driver’s license.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure seamless transition and customer service success.
• Follow up with members post-enrollment to answer questions and provide plan updates.
• Act as front-line support with members, facilities, and care teams to meet member and plan needs.
• Develop and maintain relationships with regional providers/facilities to support network adequacy.
• Meet with members and/or families monthly to review needs and progress.
• Report any dissatisfied items to the plan and track issues.
• Maintain reporting on member status, facility calendars, and issue tracking.
• Ensure all interactions comply with CMS regulations.
• Oversee services for a group of nursing facilities; ensure coverage for each member in the assigned facilities.
• Other responsibilities as assigned.

Skills

Interpersonal skills

Customer service

Communication

Organizational skills

Attention to detail

Travel willingness

CMS compliance

Tools

Microsoft Office Suite

Job description

American Health Advantage is seeking a customer-service focused leader to support local service areas as a Member Advocate. You will coordinate with Insurance Producers after enrollment, follow up with members, and serve as a front-line contact for members and care teams.

Responsibilities include maintaining provider relationships, monthly member meetings, and robust reporting while ensuring CMS compliance across facilities in your region.