Member Advocacy Coordinator

The Quality and Value Based Care area strives to develop a "best in class" service model and experience for our senior population. Our team works closely with other associates and business areas that support Medicare Advantage members in an effort to meet and exceed customer expectations and continue driving toward strategic improvement.

The Member Advocacy Coordinator develops member outreach campaign schedules and supports a team of Member Advocates to ensure they are efficiently delivering personalized and effective assistance to meet the needs of members with elevated healthcare needs.

The incumbent researches and responds to escalated or complex member inquiries under minimal supervision, working with other departments if necessary to resolve problems and ensure a positive member experience.

The Coordinator proactively identifies knowledge gaps, upcoming work process changes, or Medicare requirement updates for their assigned associates and develops job aids and/or training materials as needed.

Support is provided on Blue Advantage member issues to management and professionals in Medicare Advantage and Quality Management, Healthcare Services, Customer Service, Claims, Health Management, Sales, Marketing, Legal, Enrollment Services and other areas, communicating with all levels of management and associates in order to resolve issues.

Multiple tasks and concurrent projects are handled, prioritizing work to meet goals while ensuring accuracy of information and effective resolution of member issues.

Member Advocacy daily workflow is monitored and adjusted by the Coordinator, and the incumbent makes operational/employee relations decisions in the absence of a manager.

The Member Advocacy Coordinator serves as a liaison for system operations and coordinates completion of support tickets, training and testing with the Member Advocacy team.

The coordinator will respond to and fulfill reporting requests as needed.

The Member Advocacy Coordinator will assist on Medicare Advantage member issues, including interacting directly with the Centers for Medicare and Medicaid Services (CMS) as needed during meetings or audits.

• Bachelor's degree or upon hire commit to actively pursue a bachelor's degree
• Expert knowledge of Blue Advantage contract and benefit structure and Medicare Advantage guidance
• Knowledge of dental and medical review guidelines
• Knowledge of the benefit administration process
• Experience working with Microsoft Office products
• Excellent oral and written communication skills
• Experience researching and analyzing problems to identify solutions
• Experience handling multiple projects with various priorities and prioritizing member-driven deadlines appropriately
• Willingness to work effectively as a member of a team
• Experience exercising sound judgement to make key decisions independently
• Experience interacting with all levels of staff
• Experience resolving escalated and complex member issues
• Willingness to travel overnight if required
• Experience handling both member and provider calls preferred
• Experience developing and facilitating training classes preferred
• Experience working as a Member Advocate is a plus
  

The work schedule for this position will be hybrid (onsite/remote). Business areas reserve the right to require associates to return to the office as needed, based on performance or other business considerations. A hybrid work schedule is subject to amendment or termination at any time by the Company.

By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.
We appreciate your interest in Blue Cross and Blue Shield of Alabama 'The Company'. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.
Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association