Member Advocate
Member Advocate
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Location:
Calmont Operations BuildingDepartment:
Member ServicesShift:
First Shift (United States of America)Standard Weekly Hours:
40Summary:
The Member Advocate will serve as a Liaison between the Members and Cook Childrens 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.Additional Information:
Education and Experience
1. High School Diploma or Equivalent required
2. Bilingual (English/Spanish) required. Must pass Spanish test prior to hire.
3. Must have 12 years experience in Community Outreach or Member Advocate services.
4. Must have 12 years experience working with health insurance in a health plan setting and be knowledgeable of health insurance terminology.
Licensure Registration and/or Certification
Community Health Worker certification required to obtain within 1 year of hire
Valid Drivers License required.
Knowledge Skills & Abilities
1. Knowledge of state Managed Care Programs (Medicaid CHIP/CHIP Perinatal) including healthcare advocacy required.
2. Excellent oral and written communication skills a must as will be required to draft member educational materials.
3. Must be able to handle multiple tasks at once and maintain organization.
4. Prioritizing and time management skills are a must. Must be flexible and comfortable working in an environment that includes constant change to program requirements.
5. Strong problemsolving skills and the ability to make independent decisions including the ability to manage difficult callers and resolve any departmental conflicts that may arise.
6. 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.
7. Efficient in Microsoft Office (Word Excel Access Outlook PowerPoint) including the ability to document quickly and accurately in between calls.
About Us:
Cook Childrens Health Plan
Cook Childrens Health Plan provides vital coverage to nearly 120000 people in lowincome families who qualify for governmentsponsored programs in our six county service region. Cook Childrens Health Plan provides health coverage for CHIP CHIP Perinatal STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant Johnson Denton Parker Hood and Wise.
Cook Childrens is an EOE/AA Minority/Female/Disability/Veteran employer.
Employment Type
Full-Time
