Current jobs related to Member Advocate Nurse - Houston - Texas Children's Hospital
-
Guest Advocate
19 hours ago
Houston, Texas, United States Target Full timeAbout TargetTarget is a Fortune 50 company with over 400,000 team members worldwide, operating as one of America's leading retailers. Our purpose is to help all families discover the joy of everyday life, and we prioritize relationships, fuel, and develop talent by creating growth opportunities.Job SummaryWe are seeking a Guest Advocate to join our team,...
-
Operational Excellence Advocate
4 weeks ago
Houston, Texas, United States Camillo Companies Full timeCompany: Camillo CompaniesJob Title: Operational Excellence AdvocateDepartment: Operational ExcellenceReports to: VP of Service InnovationStatus: Full Time / Salary / ExemptKey Responsibilities:Define Goals: Establish project goals, objectives, and essential performance metrics.Engage Stakeholders: Work collaboratively with key stakeholders, project leaders,...
-
Customer Service Advocate I
1 week ago
Houston, United States Harris Health System Full timeResponsible for accomplishing their primary goal of providing support and rendering Excellent Customer Service by addressing all Health Plan Member's calls related to inquiries, questions and concerns in all areas including enrollment, benefit interp Customer Service, Advocate, Service, Retail, Healthcare, Customer
-
Behavioral Health Care Advocate in Louisiana
2 days ago
Houston, Texas, United States UnitedHealth Group Full timeUnlock Your Potential as a Field-Based Behavioral Health Care AdvocateAt UnitedHealth Group, we're committed to helping people live healthier lives and making the health system work better for everyone. As a Field-Based Behavioral Health Care Advocate, you'll play a vital role in promoting recovery and resiliency for individuals in need.Key...
-
Junior Client Advocate
4 weeks ago
Houston, Texas, United States Willis Towers Watson Full timeThe Client Relationship Associate plays a crucial role in fostering client connections, formulating strategies, and executing initiatives at the insurance program level. This position collaborates closely with a Producer and a Client Advocate within one of our Industry Vertical Divisions (IVD) or Geographical Divisions.Industry Vertical Divisions: Retail &...
-
**Registered Nurse
2 weeks ago
Houston, Texas, United States Spring ISD Full timeJob SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at Spring ISD. As a Health Advocate, you will play a critical role in supporting the education process by modifying or removing health-related barriers to learning in individual students and promoting an optimal level of wellness and safety for students and...
-
Litigation Advocate for Personal Injury
4 weeks ago
Houston, Texas, United States Jobot Full timeBilingual Personal Injury Attorney Wanted for Dynamic Legal PracticeThis Jobot Job is hosted by: Jasmine RobinsonAre you a fit? Easy Apply now by clicking the "Apply Now" buttonand sending us your resume.Salary: $130,000 - $150,000 per yearAbout Us:We are a thriving personal injury law firm focusing on cases involving vehicular accidents and other serious...
-
Member Concierge Representative
3 weeks ago
Houston, Texas, United States Apex Health Solutions Full timeJob SummaryWe are seeking a highly skilled and compassionate Member Concierge Representative to join our team at Apex Health Solutions. As a key member of our client-facing team, you will play a critical role in providing exceptional service to our clients and their members.Key ResponsibilitiesCompliance and Regulatory Expertise: Ensure adherence to...
-
Member Concierge Representative
3 weeks ago
Houston, Texas, United States Apex Health Solutions Full timeJob SummaryWe are seeking a highly skilled and compassionate Member Concierge Representative to join our team at Apex Health Solutions. As a key member of our client-facing team, you will play a critical role in providing exceptional service to our clients and their members.Key ResponsibilitiesCompliance and Regulatory Expertise: Ensure adherence to...
-
Customer Service Advocate II
1 month ago
Houston, United States Deans Professional Services Full time $17 - $18Job DescriptionJob DescriptionDean’s Professional Services is now hiring Healthcare Customer Service Advocates for a major managed care organization in central Houston. Candidates should have at least 1 year of customer service experience in a call center environment.The Customer Service Advocate is responsible for accomplishing their primary goal of...
-
Travel Nurse RN Position
2 days ago
Houston, Texas, United States Nurse First Full timeTravel Nursing Opportunity for RNsNurse First is seeking a skilled travel nurse RN to join our team in Houston, Texas.Job DetailsSpecialty: SICU - Surgical Intensive CareDiscipline: RNDuration: 8 weeksHours: 36 hours per weekShift: 12 hours, nightsEmployment Type: TravelNurse First offers a competitive pay package based on 12 hour shifts and 36 hours per...
-
Patient Liaison
1 week ago
Houston, Texas, United States Houston Methodist Full timeJob SummaryWe are seeking a highly skilled Patient Liaison to join our team at Houston Methodist Willowbrook Hospital. As a key member of our patient advocacy team, you will play a critical role in ensuring that our patients receive exceptional care and service.Key ResponsibilitiesAct as a patient advocate, resolving complex issues and concerns in a timely...
-
Bilingual Medicaid Eligibility Advocate
2 weeks ago
Houston, Texas, United States HCA Houston Healthcare Northwest Full timeJob SummaryThe Medicaid Eligibility Advocate is a key member of our team at HCA Houston Healthcare Northwest, responsible for conducting eligibility screenings, assessments, and counseling patients on insurance benefits and co-payments.Key ResponsibilitiesScreen and evaluate patients for existing insurance coverage, federal and state assistance programs, or...
-
Travel Nurse RN Labor and Delivery Position
3 days ago
Houston, Texas, United States Nurse First Full timeJob Title: Travel Nurse RN Labor and DeliveryNurse First is seeking a skilled Labor and Delivery RN for a travel nursing assignment in a dynamic healthcare setting.Job SummaryThis travel nursing opportunity is designed for a dedicated and compassionate Labor and Delivery RN to provide high-quality patient care in a fast-paced...
-
Client Assistance Program/PABSS Advocate
1 month ago
Houston, United States Disability Rights Texas Full timeJob DescriptionJob DescriptionJoin Disability Rights Texas and Ignite Your Passion for Disability Rights Advocacy!At DRTx we believe in supporting our employees by offering generous leave allocations including personal leave days, vacation hours, and sick leave, ensuring your well-being and work-life balance from day one. We also offer a paid winter break...
-
Mental Health Specialist
3 weeks ago
Houston, Texas, United States Youth Advocate Programs Full timeJob Summary:The Qualified Mental Health Professional – Community Services (QMHP-CS) is a key member of our team at Youth Advocate Programs, Inc. (YAP). We are seeking a highly motivated and compassionate individual to provide Targeted Case Management and Rehabilitative Services to youth with serious emotional disturbances and their families.Key...
-
Customer Advocate, ES Network Manager
1 week ago
Houston, Texas, United States Hitachi Full timeJob SummaryWe are seeking a highly skilled Customer Advocate to join our team at Hitachi Energy USA INC. As a key member of our Enterprise Solutions team, you will be responsible for delivering exceptional service to our customers, ensuring their needs are met and exceeded.Key ResponsibilitiesDevelop and maintain strong relationships with customers,...
-
Guest Advocate
5 days ago
Houston, United States Target Full timeTarget - 300 Meyerland Plaza Mall [Retail Cashier / Customer Service / Team Member] As a Guest Advocate at Target, you'll: Create a welcoming experience by authentically greeting, every guest every time; Make a connection with guests by engaging in friendly and genuine conversation throughout each transaction; Welcome guests into self-checkout and provide...
-
Guest Advocate
7 days ago
Houston, United States Target Full timeTarget - 8503 S Sam Houston Pkwy E [Retail Cashier / Customer Service / Team Member] As a Guest Advocate at Target, you'll: Create a welcoming experience by authentically greeting, every guest every time; Make a connection with guests by engaging in friendly and genuine conversation throughout each transaction; Welcome guests into self-checkout and provide...
-
RN-Labor and Delivery Travel Nursing
2 weeks ago
Houston, TX, United States Nurse First Full timeNurse First is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Houston, Texas. Job Description & Requirements ~ Specialty: Labor and Delivery ~ Discipline: RN ~ Start Date: 09/30/2024 ~ Duration: 13 weeks ~36 hours per week ~ Shift: 12 hours, nights ~ Employment Type: Travel Nurse First Job ID #52538372. Pay package is...
Member Advocate Nurse
3 months ago
We’re looking for a **Member Advocate Nurse **, someone who’s ready to grow our company. In this position you will investigate, resolve, and facilitate resolution of simple to moderately complex issues and questions reported by Health Plan members, prospective members, healthcare providers, or other entities relating to the Managed Care Organization. Acts as the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals, and/or any other Member/Provider needs. Assists and advocates for members and providers throughout the complaint and appeal process. Assists members with timely appointment scheduling. Translates medical terms into straight forward language and educate families how to navigate the healthcare system.
Think you’ve got what it takes?
**Job Duties & Responsibilities**
- Provides member support and advocacy.
- Educates members about their rights and responsibilities, which includes the complaints and appeals process.
- Advocates for members during complaints, appeals, and fear hearings; compiles all necessary information to ensure appropriate Member representation.
- Solves problems proactively and provides timely resolution to complex issues. Identifies the most appropriate course of action for problem resolution and effectively communicates the plans to those impacted. These issues frequently require research, collaboration with other departments, communications with external resources, and response creation.
- Handles difficult callers; provides timely assistance and intervention with problem calls. Addresses challenging customers and problems that require escalation outside the department.
- Monitors real-time queue and adherence reports to ensure service level and response time objectives are met; oversees real time escalation plans.
- Conducts group training sessions and the dissemination of information to team members.
- Collaborates with Claims, Eligibility, Provider Relations, Business Operations, and other Health Plan departments as needed to resolve member and/or provider issues.
- Utilizes concepts of reflection and motivational interviewing with the member and the entire family unit, through various modes of communication.
- Evaluate and initiate the Member Advocacy Process for Service Coordination Line Escalations.
- Acts as backup to monitor Service Coordination Line.
- Educates providers on network compliance and policies and procedures of the Texas Children’s Health Plan, managed care, and Medicaid.
- Assists internal and external Member Services and Case Managers by serving as a communication link and providing education on member issues and authorization process and status.
- Provides education to members about the TCHP network, access to physicians, specialists, and other providers, TCH IDS and community resources, and basic health information.
- Assists in creating a positive work environment that promotes productivity, mentoring, teamwork, and cooperation.
- Elicits and considers differing viewpoints when analyzing issues.
- Guidance on closing care gaps (e.g., No PCP, discussing switching from low quality PCPs to high quality PCPs, reminder for completion of health risk assessment, reminders for exams/tests due)
- Conduct a multi-disciplinary health and healthcare (both in the field and virtual) assessment of the assigned client incorporating all relevant aspects as defined by Texas Children’s Health Plan
- Uses nursing/clinical knowledge to assess, plan, implement, coordinate, monitor, and evaluate options and services with a primary goal of provide clinically appropriate healthcare advocacy and conflict resolution.
- Supports initial and ongoing system training.
- Evaluates, monitors, and coordinates community resources.
- Participates in quality initiatives.
**Skills & Requirements**
- Required bachelor's degree Registered Nurse or associate's degree Registered Nurse or Diploma in Nursing Registered Nurse
- Required RN - Lic-Registered Nurses by the Texas Board of Nursing or Nurse Licensure Compact
- Preferred CHW - Community Health Worker by the Texas Department of State Health Services
- Required 3 years Licensed nursing experience.