Regional Member Advocate & Care Coordinator

American Health Plans; New Orleans (LA); On-site; USD 42,000 - 65,000; Full time

Job summary

American Health Plans is seeking a customer-service focused leader to support local service areas. The role involves coordinating with insurers, following up with members, and serving as the primary contact for members and families within nursing facilities.

You will work with providers and care teams to ensure plan needs are met and regulatory requirements are followed. Responsibilities include monthly member meetings, relationship-building with facilities, and reporting on member status and

Qualifications

• Experience in a healthcare delivery setting with elderly patients (clinician, social worker or caregiver).
• Excellent interpersonal and communication skills.
• Ability to work independently and as part of a team.
• CMS regulations knowledge related to Medicare Advantage plans.

Responsibilities

• Coordinate with Insurance Producer to ensure smooth enrollment transitions.
• Follow up with members to answer questions and provide updates.
• Provide front-line support with members, facilities and care team.
• Develop and maintain relationships with key network providers within the region.
• Meet with members and/or families at least monthly.
• Maintain reporting on member status and facility calendars.
• Ensure all interactions comply with CMS regulations.
• Travel to facilities within the assigned region and manage the group of nursing facilities.
• Other duties as assigned.

Skills

Interpersonal skills

Customer service

Communication

Teamwork

Education

Associates or better

Tools

Microsoft Office

Job description

American Health Plans is seeking a customer-service focused leader to support local service areas. The role involves coordinating with insurers, following up with members, and serving as the primary contact for members and families within nursing facilities.

You will work with providers and care teams to ensure plan needs are met and regulatory requirements are followed. Responsibilities include monthly member meetings, relationship-building with facilities, and reporting on member status and