Medicaid Member Advocate (West Virginia)

CVS Health

5d

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Medicaid Member Advocate is a key position in the MHP (Mental Health Professional) Promise Agreement, which is a specialized managed care program in West Virginia designed for children in foster care, kinship care, and adoptive care, aligned with Aetna Better Health of West Virginia as its single managed care organization.

Requirements

• 3-5 years of experience in healthcare, specifically working with low-income and foster care population.
• Must reside in West Virginia.
• Willingness to travel up to 10% within the state of West Virginia.

Nice To Haves

• 5+ years of experience working in foster care or low-income populations.
• Proficiency documenting needs, efforts, and outcomes in tracking systems/CRMs (such as QuickBase) and managing multiple member cases.
• Strong verbal and written communication skills.
• Culturally sensitive, trauma‑informed, and empathetic approach when interacting with members and families.
• Excellent organization and time‑management skills, with the ability to prioritize urgent needs.
• Collaborative mindset and ability to work effectively with multidisciplinary teams and community partners.
• Problem‑solving skills to navigate complex legal, educational, welfare, and housing systems.
• Reliability and consistency in attending required meetings/rounds and completing documentation.
• Bachelor Degree in Social Work, Education or Counseling.

Responsibilities

• Responsible for interacting with the population and ensuring that our members are referred and connected to appropriate resources.
• Collaborating with Care Management Director, Mountain Health Promise care coordinators, System of Care Administrators, and the SNS (Socially Necessary Services) Liaison.
• Providing member support related to enrollment, access, and continuity of care issues.
• Supporting members throughout any grievances of appeal activities.
• Assisting members in obtaining materials in alternative formats, as applicable.
• Supporting and addressing needs of children and youth in foster care with educational needs by collaborating with transition specialists, care managers, and others that provide a supportive transition.
• Serving as an advocate for members by creating a bridge between them and community programs or resources.
• Supporting our youth's socio-psychological needs (such as security, love, approval, independence and/or achievement), specifically through individual support systems or goals, in an effort to help youth achieve support and independence.
• Supporting the transitional-aged youth with ensuring socio-psychological needs are met appropriately.
• Ensuring the IEP (Individualized Education Program) credits and needs are supported for a smooth transition from residential to community.
• Performing other duties as needed.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
• For more information, visit https://jobs.cvshealth.com/us/en/benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees