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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. Experience successfully working in a healthcare delivery setting with elderly patients as either a clinician, social worker or caregiver.

American Health Advantage needs a customer-service focused leader to support local service areas.Responsibilities <ul><li>After member is enrolled, coordinate with Insurance Producer to ensure seamless transition between enrollment/customer service success is achieved.</li><li style="color:#000000">Once member is enrolled, follow up member to ensure that any questions are answered, act as a point of contact if the member or their family needs assistance with the plan, or provide them with periodic updates about the plan;</li><li style="color:#000000">Act as front-line support as needed with the member, partner facility and integrated care team to ensure the needs of the Member and Plan are met;</li><li style="color:#000000">Develop and maintain relationships with key network providers/facilities within assigned region; support continued regional network development activities necessary to meet network adequacy requirements;</li><li style="color:#000000">Meet with the member and/or their family at least monthly;</li><li style="color:#000000">Follow up on any items that the members are dissatisfied with and report to plan accordingly;</li><li style="color:#000000">Develop and maintain reporting to include but not limited to managing member status, daily/weekly/monthly facility calendar, issues tracking/management;</li><li style="color:#000000">Ensure that ALL interactions with the member are compliant with CMS regulations;</li><li style="color:#000000">The Member Advocate will be responsible for a group of nursing facilities; the Member Advocate is responsible for ensuring that the above services are carried out for each of the members in your assigned group of facilities;</li><li style="color:#000000">Other responsibilities as assigned.Qualifications/ Requirements</li><li>Experience successfully working in a healthcare delivery setting with elderly patients as either a clinician, social worker or caregiver. Nursing home experience is preferred.</li><li style="color:#000000">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;</li><li style="color:#000000">Ability to work well with staff at each of the nursing homes in the assigned region to include nursing staff, doctors and administration staff;</li><li style="color:#000000">Ability to deliver outstanding customer service with a proven track record;</li><li style="color:#000000">Compliant, at all times, with CMS regulations regarding Medicare Advantage Plans</li><li style="color:#000000">Exceptional organizational skills</li><li style="color:#000000">Strong written and verbal communication and clear-thinking skills with the ability to synthesize complex issues into simple messages</li><li style="color:#000000">Willingness and ability to travel to facilities within your assigned region; have dependable transportation, a current driver’s license, a clean driving record, and proof of insurance;</li><li style="color:#000000">Strong proficiency in computer skills in Microsoft Office Suite products;</li><li style="color:#000000">Have suitable home work space allowing for productive office environment.</li><li style="color:#000000">Insurance or Insurance Customer Service License is preferred; however, not required.</li></ul><h4>Education</h4>Preferred<ul><li>Associates or better</li></ul><h4>Licenses & Certifications</h4>Required<ul><li>Automobile Insurance</li><li>Driver License</li></ul>Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the <a href="https://www.eeoc.gov/poster" rel="nofollow noopener noreferrer" target="_blank">Know Your Rights</a> notice from the Department of Labor.

American Health Plans

Member Advocate

Auto Insurance

Centers for Medicare and Medicaid Services (CMS)

Communication Skills

Content Management Systems (CMS)

Customer Support/Service

Driver's License

Healthcare

Insurance

Medicare

Network Support

Nursing

Nursing Home

Presentation/Verbal Skills

Regulations

Social Work

Willing to Travel

Writing Skills

Appcast Custom Questions GTM

ABOUT ACCURA HEALTHCARE: Accura HealthCare is a Midwest-based healthcare company that manages and operates over 50 skilled nursing care, assisted living, independent living, and memory care communities throughout Iowa, Minnesota, South Dakota, and Nebraska. Our Director of Social Services plans, develops, and integrates programming into residents’ care plans, providing for social, emotional and psychological needs, while taking into account each individual residents’ interests and capabilities.

HOUR

<div> Accura HealthCare of Toledo has the opportunity to welcome a Director of Social Services to join our team! Our Directors of Social Services are leaders who excel at serving, protecting and advocating for our residents and families. If this sounds like the ideal culture you desire, we welcome the opportunity to work with you! JOB HIGHLIGHTS:<ul><li> Full Time</li><li>Monday through Friday</li><li>Wage starting at $27/hr with increase depending on experience</li></ul></div><div>ABOUT OUR COMMUNITY:Accura HealthCare of Toledo is a campus community featuring a 55-bed Skilled Nursing Facility (SNF) and Stonebridge Suites of Toledo, an 18-apartment Independent Living (IL) community located in Toledo, IA. We embrace a unique, upside-down philosophy that places residents, patients, and direct care employees at the very top of the organizational chart. That includes you! We take pride in providing quality, person-centered care, in addition to fostering an environment that team members want to be a part of. If you desire an organization that creates an environment that allows both our residents and team members to thrive, consider Accura HealthCare and join us in being partners in care, family for life. ABOUT ACCURA HEALTHCARE: Accura HealthCare is a Midwest-based healthcare company that manages and operates over 50 skilled nursing care, assisted living, independent living, and memory care communities throughout Iowa, Minnesota, South Dakota, and Nebraska. From its beginning in 2016 with 9 care communities, Accura HealthCare has held true to its mission and vision while serving others. Built on the pillars of trust, integrity, accountability, commitment, and kindness, Accura HealthCare is a leader in the Midwest in providing high-quality care. Our employees play a key role in supporting our purpose, “to care for others,” while advancing our mission “to be partners in care, family for life.” OUR BRANDS: Accura HealthCare | Stonebridge Suites | Traditions Memory Care OUR VALUES: Trust. Integrity. Accountability. Commitment. Kindness.Accura HealthCare is where personal life and work life blend together to bring value and purpose to one’s existence.</div><div>JOB SUMMARY:Our Director of Social Services plans, develops, and integrates programming into residents’ care plans, providing for social, emotional and psychological needs, while taking into account each individual residents’ interests and capabilities. Working collaborative with others, your leadership supports and promotes each resident’s full potential from admission to discharge. Assists in the education regarding aging, Resident Rights, facility services, etc. Participates and contributes as a member of interdepartmental teams (IDT, QAPI), following all established policies and procedures. Utilizes staff, family, volunteers and community resources in the completion of the job duties and responsibilities.QUALIFICATIONS:<ul><li>Post-secondary education with a bachelor’s degree in Social Work and/or related field.</li><li>Must be able to relate professionally, positively, and cooperatively with residents, families, and employees.</li><li>Demonstrates leadership ability while promoting spirit of cooperation with team members.</li><li>Must be capable of performing the Essential Functions of this job, with or without reasonable accommodation.</li></ul>BENEFITS:<ul><li style="padding-left:0in">Vacation time, Sick time & Paid Holidays*</li><li style="padding-left:0in">Medical, Dental, & Vision Benefits*</li><li style="padding-left:0in">Flexible Spending Account*</li><li style="padding-left:0in">Employer Paid Life & AD&D*</li><li style="padding-left:0in">Supplemental Benefits*</li><li style="padding-left:0in">Employee Assistance Program</li><li style="padding-left:0in">401(k) with company match</li><li style="padding-left:0in">Education Assistance available through education partners</li></ul>*These benefits are available to full-time employees. 401k is available to FT and PT employees. Minnesota and Nebraska employees are eligible for Sick time regardless of status.Accura HealthCare, an Equal Opportunity Employer and leading post-acute healthcare provider based in Iowa, has communities in Iowa, Minnesota, South Dakota, and Nebraska, and growing! </div>

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Member Advocate American Health Plans

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