Member Care Ambassador

The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in.

Work Culture:

GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive. This philosophy enables us to create the health plan of the future and do our best work – Together.

GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer).

GCHP’s focuses on 5 Core Values in the workplace:

• Integrity

• Accountability

• Collaboration

• Trust

• Respect

Disclaimers:

• Flexible work schedule is based on job duties, department, organization, or business need.

• Gold Coast Health Plan will not sponsor applicants for work visas.

POSITION SUMMARY

The GCHP Member Care Ambassador is responsible for leading activities to achieve a superior member experience by supporting in, member outreach projects, marketing initiatives, health fairs, closing quality care gaps, supporting members address social drivers of health, community activities, conducting new member benefits orientations, member retention activities, vendor outreach and supporting providers at their clinic sites to answer questions that may arise and link them to the appropriate provider network team member . The Member Care Ambassador will be embedded in several community locations such as provider sites, community centers, GCHP Resource Centers and school wellness centers aimed at identifying and addressing member needs.

Amount of Travel Required: 25-50%

Work Schedule: Travel to multiple sites and locations. Work protracted and irregular hours and evening meetings or work irregular hours (including some weekends) for attendance at meetings for special projects and programs

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

ESSENTIAL FUNCTIONS

Job Function & Responsibilities

• Serves as GCHP community liaison for Members and potential Members through Outreach, Community Events, School Wellness Centers, GCHP Member Hubs and at provider clinics with the purpose of identifying and supporting to address member needs.

• Interacts face-to-face with members at provide sites, community centers, School Wellness Centers, and GCHP Resource Centers.

• Works closely with the Operations, Health Services, and Policy and Programs teams to refer and triage appropriately to these teams regarding escalated member issues.

• Works in collaboration with the Community Relations team to plan, develop, implement, and organize events and volunteers to advance the mission and goals of GCHP at their community location.

• Develops and maintain business relationships and information that will result in opportunities to increase membership/enrollment targets at their community location.

• Provides accurate information about eligibility, benefits and claim status and authorization requirements to serve members in a courteous and professional manner.

• When appropriate serves as a member of the Integrated Care Team to support member needs. Supports in conducting member assessments as well as contributing to the member care plan under the guidance of a nurse and social work staff. Can also participate in the member’s clinic visit when appropriate.

• Represents the department at internal and external meetings including, but not limited to, vendor reporting, departmental, cross-functional, community, provider, etc.

• Develops presentations including, but not limited to member retention meetings, new member advocacy, outreach activities, etc.

• Provides assistance with member-oriented events.

• Maintains strict confidentiality of all sensitive information.

• Escalates unresolved issues to the next level and/or appropriate area when necessary and timely.

• Assists members with their Medi-Cal renewal process when appropriate or refers members to the appropriate community partner to support eligibility questions / needs.

• Assis