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Member Advocate II
Centene CorporationMember Advocate II improving healthcare access for Centene’s health-plan members. Resolving grievances, coordinating providers and agencies, and conducting community-based education and training.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in member advocacy, community engagement, and health care compliance, with a strong focus on resolving access issues and improving member satisfaction. Proficient in educating diverse populations on benefits-related policies and conducting training for providers and community agencies.
Highest-signal resume keywords
Member AdvocacyHealth Care KnowledgePublic Relations ExperienceClaims Billing/Coding KnowledgeInsurance Producer License
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims BillingCoding KnowledgeHealth Care KnowledgeManaged CareMedicareMedicaidMember EducationProcess ImprovementContract ComplianceField Training
Soft Skills
CommunicationProblem SolvingInterpersonal SkillsCultural SensitivityAdvocacy
Certifications & Qualifications
Insurance Producer License
Industry Keywords
Public RelationsDiverse PopulationsCommunity CoalitionsMember ComplaintsGrievancesHuman Services AgenciesProvider SatisfactionMember SatisfactionWisconsin ResidencyMilwaukee Area
About the role
Key responsibilities & impact- Act as an advocate for members and liaison between the Health Plan and providers to ensure availability and access to care
- Establish a community presence and promote member education
- Identify and resolve systemic barriers limiting access to appropriate care
- Receive and respond to member complaints and formal grievances
- Serve as primary contact and liaison between member advocacy groups, human services agencies, providers and State entities
- Evaluate member qualifications for better benefit entitlement programs
- Conduct field trainings and face-to-face meetings with providers, members and community agencies
- Report results to senior management and recommend needed resolutions
- Recommend internal process changes to improve provider and member satisfaction
- Advise the Health Plan on contract compliance in delivery of covered services
- Perform training, orientation and coaching for performance improvement
- Educate members and providers on benefits-related policies and procedures, website promotion and education
- Investigate and resolve access and cultural sensitivity issues
- Participate in local community coalitions
- Update and revise educational materials as appropriate
- Perform other duties as assigned
- Comply with all policies and standards
Requirements
What you’ll need- Associate’s degree or equivalent experience
- 3+ years of public relations experience
- Experience working with diverse populations
- Knowledge of health care, managed care, Medicare or Medicaid
- Good driving record
- Ability to travel
- Valid driver’s license
- Claims billing/coding knowledge preferred
- Insurance producer license preferred
- Must reside in Wisconsin; Milwaukee-area residence highly preferred
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity