Overview

This job is located in Ashland, KY. SUMMARY: American Health Plans owns and manages institutional special needs plans (I-SNPs) for seniors who reside in long-term care facilities. Our plans are specifically designed to help nursing home operators enhance patient care and manage financial risk. The Member Advocate is a customer-service-focused position that supports local service areas. Member Advocates will conduct their work at partner nursing homes within a specific work region. Visit our website to learn more about American Health Plans: ESSENTIAL JOB DUTIES:To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.• Welcome all new members in accordance with established Plan processes• Visit or contact assigned members at least monthly• Develop and maintain relationships with key network providers, nursing home staff, and facilities within assigned region• Annually sponsor or assist a minimum of one group activity at each regional nursing facilities• Contact TruHealth staff or appointees at least monthly, but more often as appropriate, to discuss and ensure the needs of the Member and Plan are met; coordinate facility visits within the team to ensure necessary coverage for the facility• Document all activities as required• Follow up on any item(s) members are dissatisfied with and report to Plan accordingly• Ensure all interactions with the members are compliant with CMS regulations• Attend meetings as necessary• Other responsibilities as assigned JOB REQUIREMENTS:• Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team; must be a good listener to understand feedback from 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• Exceptional organizational skills• Willingness and ability to travel to facilities within assigned region• Have suitable home workspace allowing for productive office environment• Compliant with CMS regulations regarding Medicare Advantage Plans• Successfully complete required training• Handle multiple priorities effectively• Independent discretion• Reliable transportation• Possess clean driving record and current automobile insurance according to company policy• Maintain regular and reliable attendance• Successfully complete required training• Handle multiple priorities effectivelyRequired Computer Software/Equipment Used:• Various operating systems• Standard office equipment• Microsoft Suite applications QUALIFICATIONS:• Education:o Associate's degree preferred• Experience:o Experience in a healthcare delivery setting with elderly patients as either a clinician, social worker or caregiverpreferred• License /Education:o Associate's degree preferredo State driver's license COMPANY COMPETENCIES:• Respect - We treat people as they want to be treated, showing regard for their rights and privacy• Integrity - We emphasize honesty, fairness, and doing the right thing even when no one is watching• Teamwork - We work collaboratively to improve processes, resolve problems and reward results• Excellence - We hold ourselves to the highest standards, aspiring to zero defects in every task• Compassion - We respond to those who need help with sensitivity and a positive attitude• Professionalism - We perform our duties with skill, good judgement and politeness JOB COMPETENCIES:1. Analytical Thinking: Able to gather and analyze data and reach appropriate conclusions; solves problems in a timelymanner.2. Customer and Personal Service: Possess good interpersonal skills while dealing with emotional or difficult situations;respond promptly to customer's needs. Knowledge of principles and processes for providing personal services, includingneeds assess