Regional Member Advocate & Care Coordinator

American Health Plans; Odessa (TX); On-site; USD 42,000 - 65,000; Full time

Job summary

American Health Advantage seeks a patient-focused leader to guide local service areas and ensure high-quality member support. After enrollment, coordinate with Insurance Producer to smooth transitions and address member questions, acting as primary contact for families.

Responsibilities include frontline support with facilities and care teams, building provider relationships, meeting members monthly, tracking issues, and ensuring CMS compliance.

Qualifications

• Experience in a healthcare delivery setting with elderly patients preferred.
• Must comply with CMS regulations and maintain high ethical standards.
• Strong communication, listening, and problem-solving abilities.

Responsibilities

• Coordinate with Insurance Producer after enrollment to ensure smooth transitions.
• Follow up with members and families to answer questions and provide updates.
• Provide frontline support with facilities and care teams to meet member needs.
• Develop relationships with network providers and facilities within the region.
• Meet with members or families monthly and document status and issues.
• Maintain reporting on member status, calendars, and issues tracking.
• Ensure all interactions comply with CMS regulations.

Skills

Interpersonal skills

Communication skills

Organizational skills

Travel willingness

Driver License

Education

Associates or better

Tools

Microsoft Office

Job description

American Health Advantage seeks a patient-focused leader to guide local service areas and ensure high-quality member support. After enrollment, coordinate with Insurance Producer to smooth transitions and address member questions, acting as primary contact for families.

Responsibilities include frontline support with facilities and care teams, building provider relationships, meeting members monthly, tracking issues, and ensuring CMS compliance.