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Job description
Member Advocate Representative
Onsite-Help Center: 1300 W I-40 Frontage Rd, Gallup, NM 87301, the Molina office is located in the Food Court M-F 8:00 am- 5:00 PM Provides operational and outreach support that directly impacts compliance, enrollment growth, and community engagement—especially within key regions like McKinley County and among the Navajo/Diné speaking population. Supports day-to-day responsibilities of the Help Center, including but not limited to member/client greeting, problem resolution, member services support, translation & interpretation services.
Key Responsibilities
Member Services: Support with member ID Cards requests and KRAs
Health Risk Assessments (HRAs): Assist members in completing HRAs to ensure timely and compliant onboarding, particularly for those who do not speak English, Navajo/Diné is preferred.
Transition of Care (TOC): Fulfill contractual obligations by coordinating care for members transitioning between care settings.
Medicaid Eligibility Applications: Actively assist prospective members, significantly contributing to new enrollments.
Community Engagement: Represent Molina at outreach events to support lead generations and build brand trust.
Redetermination Outreach: Engage Navajo/Diné members to ensure continuity of Medicaid eligibility.
Broker Agent Liaison: Maintain relationships with broker agents, focusing on Northwest New Mexico, particularly McKinley County.
Impact
Lead Conversion Rates: Achieve high lead conversion rates of 85% or higher at community events and the Help Center.
Membership Growth: Directly influence membership growth through Medicaid application support.
Compliance: Contribute to regulatory and contractual compliance through TOC and redetermination outreach support.
Qualifications
Certified Community Health Worker (CHW) preferred
Presumptive Eligibility Determiner (PED)
Must Have Skills
Communication Skills: Verbal and written communication abilities to interact effectively with members, particularly in languages such as English and Diné/Navajo.
Cultural Competence: Deep understanding and sensitivity towards the cultural practices and needs of the Navajo/Diné population.
Health Risk Assessments (HRAs): Ability to train to learn the process and assist members in completing HRAs accurately and timely.
Regulatory Compliance: Knowledge of Medicaid and Medicare regulations and the ability to adhere to contractual obligations.
Community Engagement: Skills to represent Molina Healthcare at outreach events, generating leads and enhancing brand trust.
Broker-Agent Liaison: Capacity to maintain strong relationships with broker agents, particularly in Northwest New Mexico.
Problem-Solving: Ability to identify issues and develop solutions that improve member satisfaction and compliance.
Team Collaboration: Strong ability to work within a multidisciplinary team to achieve common goals.
Organizational Skills: Excellent organizational capabilities to manage multiple tasks and responsibilities efficiently.
Empathy: Genuine concern for members' well-being and the ability to provide compassionate support.
Day to Day
The Member Advocate Representative role enhances Molina Healthcare's community trust, membership growth, and compliance through direct engagement, particularly among the Navajo/Diné populations. Provides essential support in Medicaid applications, TOC, and redeterminations, they ensure continuity of care, build trust within the community, and foster relationships with community partners and brokers critical to Molina's growth strategy. Their presence and work are integral to upholding regulatory and contractual compliance, boosting membership growth, and sustaining Molina's mission of quality service and sustainable growth in New Mexico's most important regions. Required Years of experience: 1-2 Years working in Medicaid or lived experience as a Medicaid recipient or family member
Worksite address
gallup, NM, 87302, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.