Transforming the health of the communities we serve, one person at a time.
Quality Care Member Advocate
Location
United States
Posted
58 days ago
Salary
$27 - $49 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Quality Care Member Advocate
Centene Corporation
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT Position Purpose: Serves as a vital link between members and the healthcare system, focusing on improving health outcomes by identifying and closing care gaps. This role emphasizes community engagement, member education, and collaboration with providers and internal teams to ensure members receive timely, appropriate care and support. - Conduct outreach to members in the community to identify care gaps and connect them with appropriate healthcare services and resources. - Perform home visits or community-based assessments to evaluate member needs and identify social determinants of health that may prevent members from accessing preventive or follow-up care, and facilitate care coordination. - Serve as a member advocate by helping individuals navigate complex healthcare and social service systems. Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements, ensuring members receive the support needed to close care gaps and maintain continuity of care - Collaborate with providers to share quality performance data (e.g., HEDIS, CAHPS) and support improvement initiatives. - Educate members on preventive care, chronic condition management, and available community resources. - Document member interactions, care gap closures, and referrals in the appropriate systems. - Partner with internal departments (e.g., Quality, Care Management, Provider Relations) to align efforts and improve member outcomes. - Monitor and report on outreach effectiveness and care gap closure metrics. - Maintain compliance with state and federal regulations and organizational policies. - Participate in seasonal campaigns and quality initiatives to improve member engagement and health outcomes. - Serve as a community ambassador, building relationships with local organizations and stakeholders. - Performs other duties as assigned. - Complies with all policies and standards. Education/Experience: Bachelor's Degree Social Work, Public Health, Nursing, or related field; or equivalent experience required 2+ years In community health or healthcare quality required Experience working with health plan members and navigating community resources required Familiarity with Medicaid / Medicare programs and quality measures (e.g., HEDIS) required Strong communication and interpersonal skills Licenses/Certifications: LCSW- License Clinical Social Worker preferred RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred Pay Range: $27.02 - $48.55 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Related Guides
Related Job Pages
More Customer Advocate Jobs
Medicare Service Advocate
CVS HealthCVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary We are currently recruiting top talent for our Service Advocate role in our Medicare Stars Member Advocacy Center. Aetna Medicare’s Member Advocacy Center engages with our members to provide innovative, proactive, and compassionate solutions that exceed our member’s expectations. In this role, you will connect with members through many channels including outbound and inbound calls, video conferencing and SMS to answer unasked questions and resolve issues. Our service advocates have a high degree of empathy and patience. This position also requires performing a review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible and educating the member on their plan of benefits based on the campaign. The service advocate will be using several computer-based programs to service the members' needs and will need to be able to work in a metric-based production environment. We are the knowledgeable, trusted, advocates for our members. The key to our success is our people. We encourage bilingual applicants to apply. Fundamental Components/Job Description: Medicare Member Advocate: - Educates plan benefits, answers questions, and resolves issues based on campaign outreach. - Documents and tracks contacts with members. - Educates members on our self-service options - Follows campaign guidelines for exceptional service - Exceeds member expectations - Ensures that every caller is treated with respect, kindness and all questions are thoroughly answered - Respond to inquiries from our Medicare Advantage members - Connects with members to diminish service disruption and educate members on plans - Takes ownership and follows through on commitments - Create lasting relationships with our members - Work in a team and production-based environment to create world class service - Ability to navigate multiple systems - Acts as an advocate for our members Required Qualifications - Ability to creatively solve members’ problems and have desire to help and advocate for them - Problem solving with demonstrated ownership qualities - Demonstrated empathy, compassion and listening skills - Window based application knowledge Preferred Qualifications - Proven leadership skills - Demonstrate ability to de-escalate situations - Effective communication and documentation skills - Ability to quickly learn new skills and apply them - Demonstrated skills to multitask and problem solve - Healthcare and medical terminology knowledge - Medical billing and claims process experience - Bilingual preferred Education High School Diploma or GED Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $31.30 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/23/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Bilingual Client Advocate, Korean
OneDigitalFierce Advocates of Health, Success and Financial Security
• To address all employer health benefit issues as brought up by OneDigital clients and their employees • Resolving billing issues, enrollment and termination issues • Acting as liaison with insurance carriers • Answering questions relating to pertinent federal and state legislation • Maintains a full book of business based on employee lives and Client Advocate level I, II, or III while continuing to provide A+ service • Works directly with clients and employees to answer questions, resolve their issues, and logs each inquiry as an activity into D365 • Acts as a liaison with insurance carriers to resolve claims issues • Works with doctors’ offices, hospital facilities, and pharmacies to resolve claim issues, pre-authorization issues, and billing issues on behalf of employees • Assists clients with the appeal process • Answers questions relating to legislation and benefit laws regarding HIPAA and COBRA • Engages and builds strong relationships with clients • Proactively calls the client's key contact monthly to check in and fact find • Attend Client Health Fairs and Open Enrollment Meetings in person and via ZOOM • Meets with employees via ZOOM, as requested, to review benefits and provide guidance on claim issues and navigating employee benefits • Attends training opportunities to increase industry knowledge, practical abilities, and organizational skills
Customer Advocate Manager
ServiceNowServiceNow provides cloud-based services that automate enterprise information technology operations. As an employer, ServiceNow offers a challenging, collaborat
Company Description It all started in sunny San Diego, California in 2004 when a visionary engineer, Fred Luddy, saw the potential to transform how we work. Fast forward to today — ServiceNow stands as a global market leader, bringing innovative AI-enhanced technology to over 8,100 customers, including 85% of the Fortune 500®. Our intelligent cloud-based platform seamlessly connects people, systems, and processes to empower organizations to find smarter, faster, and better ways to work. But this is just the beginning of our journey. Join us as we pursue our purpose to make the world work better for everyone. Job Description The Customer Advocate Manager is a field-facing individual contributor who serves as the customer's champion during complex delivery challenges and escalations. This role bridges the gap between customer outcomes and internal ServiceNow execution, ensuring that high-impact delivery blockers are resolved through cross-functional coordination while maintaining unwavering focus on customer success, trust restoration, and accelerated adoption. The Customer Advocate Manager protects customer relationships, go-live outcomes, and renewal value by rapidly mobilizing the right resources, translating technical complexity into business clarity, and ensuring customers feel heard, supported, and confident throughout challenging delivery scenarios. This role converts escalation experiences into opportunities for deeper customer partnership and systemic delivery improvements. Key Responsibilities Customer-Centric Escalation Leadership - Serve as the primary Customer Advocate Manager and single point of accountability during high-impact delivery escalations. - Establish trust and executive transparency with customers experiencing delivery challenges, ensuring they feel supported and informed throughout resolution. - Translate technical blockers, platform constraints, and delivery risks into clear business impact and mitigation strategies for customer stakeholders. - Facilitate customer alignment and expectation management during high-risk delivery scenarios, balancing urgency with realistic resolution paths. Cross-Functional Orchestration for Customer Outcomes - Mobilize and coordinate resources across Delivery, Product, Engineering, Support, Impact, Sales, and Partners to drive rapid resolution without direct personnel authority. - Lead triage, prioritization, severity classification, and action tracking for multi-workstream escalations with customer timeline protection as the north star. - Surface customer impact, adoption risks, and renewal considerations to ensure business context drives technical decision-making. - Participate in customer-facing escalation calls, technical deep-dives, and executive briefings with focus on transparency and confidence-building. Structured Problem Solving & Technical Triage - Drive day-to-day escalation management through structured RCA (Root Cause Analysis), technical triage, and architectural evaluation. - Identify and assess technical blockers, integration patterns, data issues, platform constraints, and design decisions impacting customer timelines. - Evaluate alternative solution paths, workaround strategies, and change-order implications with customer business continuity in mind. - Document escalation scenarios, resolution paths, and customer commitments to maintain accountability and closure. Proactive Risk Mitigation & Early Warning - Identify delivery red flags and emerging risks before they escalate, working proactively with delivery teams to course-correct. - Establish clear escalation intake via CRIR (Critical Risk Intake Request) with rapid triage and prioritization protocols. - Monitor delivery health signals across assigned accounts or industry verticals, flagging patterns that threaten customer outcomes. Knowledge Enablement & Continuous Improvement - Convert resolved escalations into reusable playbooks, patterns, knowledge articles, and reference architectures that prevent future customer pain. - Feed lessons learned back into NowCreate methodology, SOW templates, risk assumptions, estimation models, and enablement content. - Provide structured inputs to Product roadmap reviews, defect prioritization, partner enablement, and delivery onboarding improvements. - Assist with partner ecosystem uplift by identifying repeat escalation patterns and coaching on customer engagement best practices. Qualifications To be successful in this role you have: - 6–10+ years in SaaS implementation, Customer Success delivery, Solution Architecture, Technical Consulting, or Customer Advocacy roles. - Proven experience managing complex enterprise implementations and multi-workstream programs with customer-facing accountability. - Strong track record in escalation environments, crisis management, or multi-party resolution scenarios where customer trust was at risk. Customer Advocacy & Influence Skills: - Exceptional executive communication and stakeholder management skills (customer, partner, internal C-level). - Ability to influence without formal authority and build trust rapidly during high-stress situations. - High emotional intelligence with capacity to remain calm, empathetic, and solution-focused under pressure. - Strong problem decomposition, hypothesis-driven analysis, and ability to simplify complexity for non-technical audiences. - Demonstrated ability to balance customer advocacy with internal ServiceNow business considerations (scope, commercials, product constraints). Preferred Experience: - Prior customer-facing roles with P&L responsibility, renewal accountability, or customer health ownership. - Experience working in SI/Partner ecosystems or multi-party delivery environments. - Industry vertical expertise (Healthcare, Federal, Financial Services, Manufacturing) with understanding of regulatory nuances (PHI, FedRAMP, PCI, SOC). - Background in Sales/SE or pre-sales risk qualification that bridges commercial and delivery perspectives. - Change management or organizational transformation experience in enterprise technology deployments. - Deep understanding of ServiceNow platform architecture, integrations, workflows, scripting, performance, and data models. - Familiarity with at least two major workflow areas (ITx, SPM, SecOps/Risk, HRSD/Employee, Healthcare, GenAI). - Knowledge of delivery lifecycle (SOW → design → build → UAT/OAT → cutover → go-live) and common failure modes at each phase. - Working knowledge of NowCreate or similar phase-based delivery methodologies. FD21 For positions in this location, we offer a base pay of $165,500 - $289,600, plus equity (when applicable), variable/incentive compensation and benefits. Sales positions generally offer a competitive On Target Earnings (OTE) incentive compensation structure. Please note that the base pay shown is a guideline, and individual total compensation will vary based on factors such as qualifications, skill level, competencies, and work location. We also offer health plans, including flexible spending accounts, a 401(k) Plan with company match, ESPP, matching donations, a flexible time away plan and family leave programs. Compensation is based on the geographic location in which the role is located and is subject to change based on work location. Additional Information Work Personas We approach our distributed world of work with flexibility and trust. Work personas (flexible, remote, or required in office) are categories that are assigned to ServiceNow employees depending on the nature of their work and their assigned work location. Learn more here. To determine eligibility for a work persona, ServiceNow may confirm the distance between your primary residence and the closest ServiceNow office using a third-party service. Equal Opportunity Employer ServiceNow is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex, sexual orientation, national origin or nationality, ancestry, age, disability, gender identity or expression, marital status, veteran status, or any other category protected by law. In addition, all qualified applicants with arrest or conviction records will be considered for employment in accordance with legal requirements. Accommodations We strive to create an accessible and inclusive experience for all candidates. If you require a reasonable accommodation to complete any part of the application process, or are unable to use this online application and need an alternative method to apply, please contact [email protected] for assistance. Export Control Regulations For positions requiring access to controlled technology subject to export control regulations, including the U.S. Export Administration Regulations (EAR), ServiceNow may be required to obtain export control approval from government authorities for certain individuals. All employment is contingent upon ServiceNow obtaining any export license or other approval that may be required by relevant export control authorities. From Fortune. ©2025 Fortune Media IP Limited. All rights reserved. Used under license. - Employee Type: Regular - Region: AMS - North America and Canada - Work Persona: Flexible or Remote
Knowledge Management, Inc. (KMI) has the leadership and experience to deliver innovative technology, logistics and management solutions to meet real mission requirements. KMI is a Minority Business Enterprise (MBE) and Small Disadvantage Business (SDB) that specializes in Logistics, Warehouse Services, Distance Learning/Training, Enterprise Solutions, Financial Management Support, Program Management, Intelligence Analysis & Threat Assessment, and Data Analytics/Operations Research. Since 1998, our solutions and services have helped our clients improve performance, drive cost and operational effectives, and map technology needs for tomorrow's requirements. Job Requisition: Logistics Strategic Advocate Location: Remote Position Type: Part-Time (20 hours per week average) Customer: Headquarters, U.S. Marine Corps, Installation & Logistics (I&L), LPI Hourly Rate: $95.00 - $101.00 Job Description: Knowledge Management, Inc. is seeking an experienced Sr. Logistician with specific experience with the Marine Corps' Information Technology portfolio and LCMS. This individual will be intimately familiar with Marine Corps logistics systems, analyzing equipment readiness trends and issues. This position will focus on analyzing logistics information systems efficacy and adequacy and making recommendations for improvement. Key Responsibilities: - Provide support to the HQMC LPI LCMS program effort. - Provide subject matter expertise for the Marine Corps Logistics IT portfolio. - Provide LCMS support over the shoulder support. - Support the production, and review of briefings intended for leadership information and decision making on Logistics IT future state. - Coordinate and obtain information internal and external to prepare spreadsheets, briefings, reports, and/or recommendations to assist in providing responses to queries as required. Minimum Qualifications: - Minimum of 20 years of experience with U.S. Marine Corps Logistics - Bachelor's degree in business, operations research, Data Analytics, Computer Science, or a similar field (Additional 4 years of experience if no degree) - Has knowledge and experience in working with Logistics IT stakeholders within HQMC I&L, MARCORSYSCOM, and LOGCOM. - Familiarity of the organization structure of the Marine Corps operating forces, the Support Establishment, Reserves, and other DoD agencies - Have a mastery of HQMC administrative organization, processes, and procedures - Proficient in SharePoint and Microsoft Suite: Word, Excel, Teams, and PowerPoint Desired Qualifications: - Prior military logistician with tours of duty at Headquarters, U.S. Marine Corps, Installations & Logistics (I&L) and/or Field Supply & Maintenance Analysis Office (FSMAO) teams Security Clearance: - Active DoD Secret security clearance required. Availability - This position is anticipated to be available on or about 18 May 2026 Benefits: All full-time employees are eligible to participate in our benefits programs: - Health, dental, and vision insurance - 401(k) retirement plan - Paid time off (PTO) and holidays - Group Term Life and Accidental Death and Dismemberment Insurance - Voluntary Term Life Insurance - Short and Long-term disability insurance Equal Employment Opportunity Statement. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. E-Verify Statement. Knowledge Management, Inc. participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, KMI is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the Form I-9. Pay Transparency Non-Discrimination Provision. Knowledge Management, Inc. will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c) Disability Statement. If you have a disability and need reasonable accommodation or assistance at any point in the application or onboarding process, please email us at marie@knowledgemanagement.com.




