[Hiring] Benefit Support Advocate @Provider Partners Health Plan

Role Description

The Benefit Services Advocate serves as the central coordination point for scheduling medical appointments and procedures for members enrolled in Institutional Special Needs Plans (ISNP) and Institutional-Equivalent Special Needs Plans (IESNP). This position works closely with long-term care facility staff, internal Benefit Services team members, and provider offices to ensure that appointments are scheduled promptly and communicated accurately. The Advocate plays a critical role in facilitating access to care by ensuring the appropriate authorization process is initiated and completed when necessary.

• Act as the primary contact for long-term care facilities requesting medical appointments or procedures for ISNP/IESNP members.
• Schedule appointments with physicians, specialists, diagnostic services, or other providers on behalf of members.
• Ensure appointments are coordinated based on provider availability, member needs, and facility resources.
• Initiate internal communication with the Benefit Services team to determine if an authorization is required for the scheduled services.
• Track and follow up on the status of authorizations and ensure timely completion prior to scheduled appointments.
• Relay appointment and authorization details back to the requesting facility or caregiver contact clearly and efficiently.
• Maintain accurate documentation in the appropriate systems for appointment requests, scheduling status, and authorization needs.
• Escalate urgent scheduling issues or barriers to care to leadership as needed to avoid delays in treatment.
• Build and maintain positive working relationships with facility staff and provider offices to support smooth coordination of care.

Qualifications

• High school diploma or equivalent required.
• Minimum of 2 years of experience in healthcare coordination, medical office scheduling, or insurance authorization processes, preferably within a managed care or long-term care setting.
• Familiarity with Medicare Advantage plans, especially ISNP or IESNP populations, is highly desirable.
• Strong interpersonal and communication skills, with the ability to manage multiple stakeholders effectively.
• Detail-oriented with excellent organizational and time-management abilities.
• Proficient in using Microsoft Office products and experience with healthcare software systems or electronic health records (EHRs) is preferred.