Healthcare Member Advocate
1 week ago
Salary: Starting pay $19.92/hr.
- Weekly Pay
- Benefit Options Available
- Start ASAP if all qualifications met
Essential Job Functions:
The Member Advocate will serve as a Liaison between the Members and the Medical Plan. The Member Advocate will help members and Authorized Representatives (LARs) navigate through the complexities of the healthcare system. The Member Advocate will serve as an expert in community resources most frequently needed by Plan Members and finding hard to reach members.
- Act as an advocate for the member and a liaison between the Health Plan and to ensure availability and access to health care.
- Identify and resolve any system barriers that limit members access to appropriate care
- Serve as primary contact for member advocacy groups, human services agencies and the State entities
- Participate in trainings from The Health Plan and Community-Based Organizations to acquire knowledge regarding the special healthcare needs of members and update any educational materials as appropriate
- Participate in local community organizations
- Coordinate issue resolution, work with other plan departments as needed to resolve member complaints/grievances and member inquiries ensuring that all information is collected and documented accurately and sent in a timely manner to the Compliance Department
- Receive and respond to member complaints and formal grievances
- Identify potential access barriers and resolve as indicated in the grievance procedure
Qualifications:
- Must be bilingual with fluency in both English and Spanish with excellent oral and written communication skills
- Must pass a Spanish proficiency examination prior to hire
- Must have 1-2 years’ experience in community outreach or Member Advocate services
- Must have 1-2 years' experience working with health insurance in a health plan setting and be knowledgeable of health insurance terminology
- Excellent oral and written communication skills a must as will be required to draft member educational materials
- Prioritizing and time management skills are a must
- Strong problem-solving skills and the ability to make independent decisions including the ability to manage difficult callers and resolve any departmental conflicts that may arise
- Required to work independently as well as within a team environment
- Efficient in Microsoft Office (Word, Excel, Access, Outlook, PowerPoint) including the ability to document quickly and accurately in between calls
- CHW License required upon hire
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