Member Advocate

Immediate need for a talented Member Advocate. This is a 06+ months contract opportunity with long-term potential and is located in Austin TX (Remote). Please review the job description below and contact me ASAP if you are interested.
 
Job ID: 25-77594
 
Pay Range: $16 - $17/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities: 

• Working Hours: We now work 7 days a week. We are needing recruits with OPEN availability:
• Monday – Friday – 6 am to 7 pm CST or 8 am- 5 pm
• 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.
• Story Behind the Need – Business Group & Key Projects:
• Customer service skills (assist members locating, PCP, specialist, and community resources.
• Assist with daily assignments such as PCP changes, id cards, electronic mai
• The member advocate outreaches members and providers daily.
• Compelling Story & Candidate Value Proposition
• The team is very knowledgeable and works like a small family and always willing to help each other with any barriers. The job is permanently remote, and the team meets twice a week on camera for questions and to help each other with difficult cases or complaints. We meet once a month for team meetings on camera for updates and changes, and meet with employee once a month to review performance and metrics.

 
Key Requirements and Technology Experience:  

• Key skills; Customer service, Medicare/Healthcare, member advocate outreaches, Call centre 
• High school diploma or GED.
• Act as an advocate for the Member and a liaison 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.

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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