Member Advocate
Company: Disability Solutions
Location: Fort Worth
Posted on: September 18, 2024
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Job Description:
Location:Calmont Operations BuildingDepartment:Member
AdvocateShift:First Shift (United States of America)Standard Weekly
Hours:40Summary: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.Additional Information:Education and Experience1.
High School Diploma or Equivalent required2. Bilingual
(English/Spanish) required. Must pass Spanish test prior to hire.3.
Must have 1-2 years' experience in Community Outreach or Member
Advocate services.4. Must have 1-2 years' experience working with
health insurance in a health plan setting and be knowledgeable of
health insurance terminology.Licensure, Registration, and/or
CertificationCommunity Health Worker certification required to
obtain within 1 year of hireValid Driver's License
required.Knowledge, Skills & Abilities1. 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 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.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 Children's Health Plan
Cook Children's Health Plan provides vital coverage to nearly
120,000 people in low-income families who qualify for
government-sponsored programs in our six county service region.
Cook Children's 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 Children's is an
EOE/AA, Minority/Female/Disability/Veteran employer.
Keywords: Disability Solutions, Fort Worth , Member Advocate, Other , Fort Worth, Texas
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