Sunshine Health · 7 hours ago

Member Advocate I

Florida, United States

Full-time

Remote

Entry Level

$18.66/hr - $31.73/hr

3+ years exp

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Hospitals and Health Care

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Responsibilities

Act as an advocate for the Member and a liaison between the Health Plan and Provider(s) to ensure availability and access to care.

Receive and respond to Member complaints and formal grievances and identify potential access barriers and resolve as indicated in the grievance procedure.

Investigate and resolve access and cultural sensitivity issues identified by Member Services staff, State staff, providers, advocacy organizations and recipients.

Participate in local community organizations to acquire knowledge and insight regarding the special health care needs of Members and update and revise educational materials as appropriate.

Serve as primary contact for Member advocacy groups, human services agencies and the State entities.

Maintain confidentiality per HIPAA guidelines.

Qualification

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Healthcare experienceMedicare experienceMedicaid experienceHIPAA compliance