Regional Member Advocate & Care Coordinator

American Health Plans; Lubbock (TX); On-site; USD 48,000 - 64,000; Full time

Job summary

American Health Advantage seeks a customer-service oriented leader to support local service areas and ensure member satisfaction.

The role involves coordinating enrollment transitions, ongoing member contact, and front-line support for members, facilities, and care teams across nursing facilities in the assigned region.

Travel to facilities is required; CMS compliance and strong communication are essential for effective regional network development and ongoing member advocacy.

Qualifications

• Experience in healthcare delivery with elderly patients; nursing home preferred.
• Excellent interpersonal and listening skills; ability to work independently.
• Ability to collaborate with nursing home staff and administration.
• Strong customer service focus with CMS regulation familiarity.
• Excellent organizational and written/verbal communication.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure smooth transitions.
• Follow up with members and families to answer questions and provide updates.
• Serve as front-line support for members, facilities, and care teams.
• Develop and maintain relationships with regional network providers.
• Meet with members or families at least monthly.
• Ensure CMS compliance for all member interactions.
• Generate reports on member status, calendars, and issues.

Job description

American Health Advantage seeks a customer-service oriented leader to support local service areas and ensure member satisfaction.

The role involves coordinating enrollment transitions, ongoing member contact, and front-line support for members, facilities, and care teams across nursing facilities in the assigned region.

Travel to facilities is required; CMS compliance and strong communication are essential for effective regional network development and ongoing member advocacy.