Member Advocate

Cook Children's Health Care System•Fort Worth, TX

1d•Onsite

About The Position

The Member Advocate will serve as a Liaison between the Members and Cook Children's Health Plan (CCHP). The Member Advocate will help Members and their Legally Authorized Representatives (LARs) navigate through the complexities of the healthcare system. The Member Advocate will guide and educate Members on their benefits, Member Rights & Responsibilities, Complaints and Appeals all while maintaining cultural sensitivity and confidentiality. The Member Advocate will deliver a highly satisfactory customer experience by responding to every inquiry immediately and directly, when possible, or by collaborating with other CCHP team members involved in the delivery of care to our Members. The Member Advocate will serve as expert in community resources most frequently needed by CCHP Members and finding hard to reach members.

Requirements

High School Diploma or Equivalent required
Bilingual (English/Spanish) required. Must pass Spanish test prior to hire.
Must have 1-2 years’ experience in Community Outreach or Member Advocate services.
Must have 1-2 years' experience working with health insurance in a health plan setting and be knowledgeable of health insurance terminology.
Community Health Worker certification required to obtain within 1 year of hire
Valid Driver's License required.
Knowledge of state Managed Care Programs (Medicaid, CHIP/CHIP Perinatal) including healthcare advocacy required.
Excellent oral and written communication skills a must as will be required to draft member educational materials.
Must be able to handle multiple tasks at once and maintain organization.
Prioritizing and time management skills are a must.
Must be flexible and comfortable working in an environment that includes constant change to program requirements.
Strong problem-solving skills and the ability to make independent decisions including the ability to manage difficult callers and resolve any departmental conflicts that may arise.
Required to work independently as well as within a team environment, prioritize and track outstanding work while acknowledging that all CCHP Members are the number one priority.
Efficient in Microsoft Office (Word, Excel, Access, Outlook, PowerPoint) including the ability to document quickly and accurately in between calls.