Member Advocate Specialist, DentaQuest South TX ( Bilingual in Spanish

Position: Member Advocate Specialist, DentaQuest South TX ( Bilingual in Spanish)
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* Job Description:

** The Member Advocate Specialist (MAS) has direct oversight for the advocacy of members included but not limited to preventive dental care, access to care, education, complaints and grievances, appeals, and dental home. In addition, attends virtual or in-person health fairs and community events, as directed by business need.

Establish and maintain community relationships that provide for participation in health care initiatives and programs to create dental awareness. These relationships will aid in the member advocate’s ability to refer members to community resources that can accommodate members’ needs if the services are not medically necessary covered dental services.

This includes tasks such as assisting members with finding a dental home, coordinate case management for various populations including special needs and Children of Migrant Farm Workers (TX only), maintaining the data for reporting dental home activities, and coordinating outreach efforts.

Submit tracking and trending reports related to dental home, member advocacy, migrant worker, care coordination and case management performance measures to Denta Quest management.  Help maintain and increase dental access requirements in compliance with dental home components, Medicaid, CHIP and Frew guidelines (for TX only).Other duties as assigned.  Member’s rights and responsibilities Non-capitated services (benefits that are excluded from medically necessary services such as transportation) Other duties as assigned.  

Bachelor’s degree and/or 3 years of related experience in healthcare, advocacy or customer service.

Demonstrated proficiency in claims processing and issue resolution.  Knowledge of clinical and industry terminology and procedures.  Self-motivated, and ability to work with little supervision.  Strong analytical skills.  Strong problem-solving skills and the ability to make independent decisions.  Strong written and oral communication skills.  Knowledge of general computer software. (Outlook, Excel and MS Word) Ability to communicate in an active office environment.  

Ability to travel throughout the State of Texas as needed.

Ability to efficiently operate all job-related office equipment.  Ability to communicate via telephone and in writing.  Ability to read and view computer screen.  
* Background in education or community advocacy.
* Enjoys meeting and talking to people.

Bilingual language skills preferred.  Experience working in a managed care environment is preferred.  Knowledge of healthcare advocacy activities is preferred Community Engagement Experience Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal compute).  Ability to travel or move about within and outside serviced facilities required.

** Salary:
** Salary Range: $49,200 - $66,400    At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business.

We are dedicated to creating a work environment where everyone is rewarded for their contributions.
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