Activities Director

Member Advocate

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. This position requires reasonable work-from-home space, as no formal office space or work location is provided. However, Member Advocates will conduct their work at partner nursing homes within a specific work region.

Essential

Job Duties:

• 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 Tru Health 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
• Required Computer Software/Equipment Used:
  Various operating systems, Standard office equipment, Microsoft Suite applications

Qualifications:

• Education:
  
  Associates or better preferred
• Experience:
  
  Experience in a healthcare delivery setting with elderly patients as either a clinician, social worker or caregiver preferred
• License/
  
  Education:
  
  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:

• Analytical Thinking:
  Able to gather and analyze data and reach appropriate conclusions; solves problems in a timely manner
• Customer and Personal Service:
  Possess good interpersonal skills while dealing with emotional or difficult situations; respond promptly to customer's needs
• Accountability:
  Accepts responsibility for own decisions, actions, and results; able to maintain dependable behavior in times of crisis or complexity
• Attendance:
  Is…