Member Advocate
On-siteSeymour, Indiana, United States
Job Summary
Coordinate with Insurance Producers to ensure seamless enrollment transitions and follow up with members to answer questions and provide periodic plan updates. Act as a front-line support point of contact for members and their families, meeting monthly to address needs and report on dissatisfaction. Maintain relationships with key network providers and facilities within the assigned region while managing member status, facility calendars, and issue tracking. Ensure all interactions comply with CMS regulations regarding Medicare Advantage Plans. This role involves overseeing a group of nursing facilities for American Health Advantage, requiring travel to facilities within the region and strong interpersonal skills to work with nursing staff, doctors, and administration.
Required Qualifications
- Experience successfully working in a healthcare delivery setting with elderly patients as either a clinician, social worker or caregiver
- Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team
- must be a good listener to understand feedback raised by the family
- Ability to work well with staff at each of the nursing homes in the assigned region to include nursing staff, doctors and administration staff
- Ability to deliver outstanding customer service with a proven track record
- Compliant, at all times, with CMS regulations regarding Medicare Advantage Plans
- Exceptional organizational skills
- Strong written and verbal communication and clear-thinking skills with the ability to synthesize complex issues into simple messages
- Willingness and ability to travel to facilities within your assigned region
- have dependable transportation
- a current driver's license
- a clean driving record
- proof of insurance
- Strong proficiency in computer skills in Microsoft Office Suite products
- Have suitable home work space allowing for productive office environment
Desired Qualifications
- Nursing home experience
- Insurance or Insurance Customer Service License
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