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Member Advocate

American Health PartnersTopeka, KS

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Job Description

JOB SUMMARY:

The Member Advocate is a customer-service focused position that will support local service areas. The position is considered a work-from-home position as no formal office space/work location is provided; however, the Member Advocate will conduct a large portion of work at partner nursing homes within a specific work region.

ESSENTIAL JOB DUTIES:

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.

  • Welcome all new members in accordance with established Plan processes
  • Visit or contact assigned members at least monthly
  • Develop and maintain relationships with key network providers, nursing home staff, and facilities within assigned region
  • Annually sponsor or assist a minimum of one group activity at each regional nursing facilities
  • Contact TruHealth staff or appointees at least monthly, but more often as appropriate, to discuss and ensure the needs of the Member and Plan are met
  • Document all activities as required
  • Follow up on any item(s) members are dissatisfied with and report to Plan accordingly
  • Ensure all interactions with the members are compliant with CMS regulations
  • Attend meetings as necessary
  • Other responsibilities as assigned

JOB REQUIREMENTS:

  • Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team; must be a good listener to understand feedback from 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
  • Exceptional organizational skills
  • Willingness and ability to travel to facilities within assigned region
  • Have suitable home workspace allowing for productive office environment
  • Compliant with CMS regulations regarding Medicare Advantage Plans
  • Successfully complete required training
  • Handle multiple priorities effectively
  • Independent discretion
  • Reliable transportation
  • Possess clean driving record and current automobile insurance according to company policy
  • Maintain regular and reliable attendance
  • Successfully complete required training
  • Handle multiple priorities effectively

Required Computer Software/Equipment Used:

  • Various operating systems
  • Standard office equipment
  • Microsoft Suite applications

QUALIFICATIONS:

  • Education:

o Associate's degree preferred

  • Experience:

o Experience in a healthcare delivery setting with elderly patients as either a clinician, social worker or caregiver preferred

  • License /Education:

o Associate's degree preferred

o State driver's license

EQUAL OPPORTUNITY EMPLOYER

This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.

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