Member Advocate II (Bilingual)
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About The Position
As a Customer Care professional at Centene, you will act as an advocate for our 28 million members and serve as a liaison between the Health Plan and Providers to ensure availability and access to care. Your role will involve establishing a community presence, promoting member education, and identifying and resolving systemic barriers that limit access to appropriate care. You will receive and respond to member complaints and formal grievances, serving as the primary contact between member advocacy groups, human services agencies, providers, and State entities. Additionally, you will evaluate member qualifications for better benefit entitlement programs and conduct field trainings and face-to-face meetings with providers, members, and community agencies, reporting results to senior management for necessary resolutions. Your responsibilities will also include recommending changes in internal processes to improve provider and member satisfaction, advising the Health Plan on contract compliance, and educating members and providers regarding policies and procedures related to benefits. You will investigate and resolve access and cultural sensitivity issues identified by various stakeholders and participate in local community coalitions to gain insights into the special health care needs of members, updating educational materials as appropriate. A valid driver's license and the ability to travel are required.
