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 TruHealth 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
• Integrity
• Teamwork
• Excellence
• Compassion
• Professionalism

Job Competencies:

• Analytical Thinking
• Customer and Personal Service
• Accountability
• Attendance
• Communication
• Ethical Behavior
• Initiative
• Job and Industry Knowledge
• Productivity and Quality of Work
• Teamwork

Scope and Level of Work:

• Complexity: assignment is performed within an established framework under general instructions but requires simultaneous coordination of assigned functions or projects in various stages of completion.
• Decision Making: Exercises judgment and discretion.
• Communications: Contacts with the public or employees where explanatory or interpretive information is exchanged, defended, and gathered and discretion and judgment are required within the parameters of the job function.
• Supervision Received: Performs work with supervisory oversight. Under general supervision, receives assignments and is expected to carry them through to completion with substantial independence. Work is reviewed for adherence to instructions, accuracy, completeness, and conformance to standard practice or precedent. Recurring work clearly covered by guidelines may or may not be reviewed.
• Social Interaction: Interpersonal contacts with individuals within or outside the organization may occasionally result in unexpected demands, requiring restructuring of priorities, and the performance of several related tasks simultaneously.
• Impact of Actions: An error in action may affect more than one work department in the organization. Errors have the potential to cause avoidable costs and inconveniences.

Supervisory Responsibilities:

• Does not have supervisory responsibilities
• Occasionally needs manager's direction due to extraordinary circumstances

Working Conditions:

• Audio-Visual: Hearing: Good
• Ability to lift to 10 pounds
• Subject to standing, walking, sitting
• Position may require flexible hours, unscheduled overtime or occasional week-end work
• Must be able to speak and write in English
• Daily Travel required

Safety Expectations:

• Work safely and follow safety rules
• Report unsafe working conditions and behaviors
• Take reasonable and prudent actions to prevent others from engaging in unsafe practices

Equal Opportunity Employer:

This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.