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Member Advocate I - 210113
Job Description
Position Purpose: Act as an advocate for the Member and a liaison between the Health Plan and Provider(s) to ensure availability and access to care. Establish a community presence, promote Member education, identify and resolve any systemic barriers that limit Members access to appropriate care.
Education/Experience: High school diploma or equivalent. 3+ years of customer service experience in a healthcare environment. Medicare and/or Medicaid experience preferred.
Bilingual in Spanish preferred.
• Receive and respond to Member complaints and formal grievances and identify potential access barriers and resolve as indicated in the grievance procedure.
• Investigate and resolve access and cultural sensitivity issues identified by Member Services staff, State staff, providers, advocacy organizations and recipients.
• Participate in local community organizations to acquire knowledge and insight regarding the special health care needs of Members and update and revise educational materials as appropriate.
• Serve as primary contact for Member advocacy groups, human services agencies and the State entities.
• Maintain confidentiality per HIPAA guidelines.
IND123
Education/Experience: High school diploma or equivalent. 3+ years of customer service experience in a healthcare environment. Medicare and/or Medicaid experience preferred.
Bilingual in Spanish preferred.
• Receive and respond to Member complaints and formal grievances and identify potential access barriers and resolve as indicated in the grievance procedure.
• Investigate and resolve access and cultural sensitivity issues identified by Member Services staff, State staff, providers, advocacy organizations and recipients.
• Participate in local community organizations to acquire knowledge and insight regarding the special health care needs of Members and update and revise educational materials as appropriate.
• Serve as primary contact for Member advocacy groups, human services agencies and the State entities.
• Maintain confidentiality per HIPAA guidelines.
IND123
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Ready to explore exciting job opportunities in the vibrant city of Farmers Branch, Texas? Nestled in the heart of the Dallas-Fort Worth metroplex, this dynamic area boasts a thriving economy, exceptional quality of life, and a welcoming community. With easy access to major highways, top-notch dining options like the local favorite Amigos Restaurant, the renowned Farmers Branch Historical Park, and cultural hotspots such as the Outlaw Blues and Jazz Club, there's no shortage of reasons to consider a career in this charming city. Discover your next career move in Farmers Branch and experience the perfect blend of work and play!