Member Advocate II

Centene
Wisconsin, Milwaukee
Workplace: HybridFull timeUSD 23.23 - 39.61 hourlyFunction: Customer Support (Service Desk)Experience: 3+ yearsEducation: associatesSkills: ["Advocacy","Problem-solving","Stakeholder management","Coaching","Communication"]

Serve as a member advocate and liaison between the health plan and providers to ensure access to covered care. Handle member complaints and formal grievances, identify systemic access barriers, and coordinate responses with member advocacy groups, human services agencies, providers, and state entities. Evaluate member eligibility for benefit entitlement programs, conduct field trainings and face-to-face sessions, recommend process improvements, and support coaching and education for providers, physician practices, and community agencies.

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FursaFursa
Centene
Centene
6 days ago

Member Advocate II

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Source: Company careers pageValidated by: Fursa AI
Last checked: 7 hours agoStatus: Live

Job Summary

Serve as a member advocate and liaison between the health plan and providers to ensure access to covered care. Handle member complaints and formal grievances, identify systemic access barriers, and coordinate responses with member advocacy groups, human services agencies, providers, and state entities. Evaluate member eligibility for benefit entitlement programs, conduct field trainings and face-to-face sessions, recommend process improvements, and support coaching and education for providers, physician practices, and community agencies.
Location: Wisconsin, Milwaukee
Workplace: Hybrid
Employment Type: Full time
Job Function: Customer Support (Service Desk)
Seniority: Mid level

Key Responsibilities

  • •Act as an advocate for members and liaison between the health plan and providers to ensure availability and access to care.
  • •Receive and respond to member complaints and formal grievances, identify access barriers, and resolve issues through the grievance procedure.
  • •Serve as primary contact and liaison between member advocacy groups, human services agencies, providers, and state entities.
  • •Evaluate member qualifications for benefit entitlement programs and recommend changes to internal processes to improve provider and member satisfaction.
  • •Conduct field trainings and face-to-face meetings; investigate access and cultural sensitivity issues and participate in local community coalitions.
Travel: Medium travel

Pay and Benefits

Salary: USD 23.23 - 39.61 hourly
Perks:Health Insurance401kEquityPaid Leave

Key Requirements

  • •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; claims billing/coding knowledge preferred.
  • •Valid driver’s license; insurance producer license preferred.
Experience:3+ years
Education:Associate's
Skills:AdvocacyProblem-solvingStakeholder managementCoachingCommunication
Licenses:Valid driver’s licenseInsurance producer license

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn