Member Advocate – Field

Initiates engagement with assigned members to introduce the program and gather updated member demographic information with speed, accuracy, and a positive attitude.
Schedules completion of the assessment based on the member’s preferences and the assigned care manager’s schedule.
Accurately and consistently documents each call in the member’s electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements.
Protects the confidentiality of member information and adheres to company policies regarding privacy/ HIPAA
Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate.
Conducts triage, connecting members with appropriate care team personnel including care managers and customer service when needed.
Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm.
Demonstrates an outgoing, enthusiastic, and caring presence over the telephone.
Act as a Medicaid recertification specialist for the team.

• 2 years of experience preferably in customer service, telemarketing, Medicaid, and/or sales.
• Experience with computers, including knowledge of Microsoft Word, Outlook, and Excel - data entry and documentation within member records is preferred.
• Must reside in New Jersey and be able to travel 25-40% to attend member meetings.
• Call center experience preferred.
• Familiarity with basic medical terminology preferred.
• Flexibility with work schedule to meet business needs.
• Strong organizational skills, including effective verbal and written communications skills.
• Bilingual desired.

Demonstrates strong customer service skills with a focus on member engagement, compliance, and effective communication. Proficient in managing multiple priorities while maintaining a positive and empathetic approach in challenging situations.

• Customer Service Experience
• Medicaid Recertification
• Call Center Experience
• Microsoft Office Proficiency
• Bilingual Communication

• Data Entry
• Documentation
• Medical Terminology
• Member Engagement
• Assessment Scheduling

• Empathy
• Organizational Skills
• Verbal Communication
• Written Communication
• Adaptability

• HIPAA Compliance
• Member Confidentiality
• Telemarketing
• Care Management
• Customer Service

• Microsoft Word
• Microsoft Outlook
• Microsoft Excel