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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.

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