Health Plan Liaison - ProCare Houston (19103)

Role Summary

ProCare Advantage is seeking a dedicated and motivated Health Plan Liaison to serve as the primary point of contact between our members, partner facilities, and care teams. This role is responsible for building and maintaining strong relationships, supporting member satisfaction, staff education, and ensuring timely resolution of issues. The Health Plan Liaison will work primarily onsite at assigned facilities across Texas, with frequent travel to regions including San Antonio, Beaumont, Dallas, and others as needed.

Key Responsibilities

• Demonstrated ability to work independently with minimal supervision.
• Collaborate effectively within cross-functional teams to achieve departmental goals.
• Serve as the first point of contact for providers, facility staff, members, and family representatives; address inquiries and resolve issues promptly within established timeframes.
• Conduct daily visits to assigned facilities to build relationships, identify needs, and escalate concerns to the appropriate ProCare department.
• Support prospective members and families by answering plan-related questions and coordinating a seamless handoff to licensed Sales Agents.
• Maintain regular follow-up with members and families to ensure satisfaction, address concerns, and provide updates on plan benefits.
• Act as front-line support in collaboration with partner facilities and integrated care teams to meet member needs and plan objectives.
• Organize and facilitate on-site events to showcase ProCare Advantage and educate potential members about plan benefits.
• Deliver ongoing education to facility staff on the advantages of the plan.
• Engage with members considering disenrollment, working to resolve concerns and support retention.
• Develop and maintain strategic relationships with key providers and facilities, supporting network adequacy and growth.
• Administer quarterly member satisfaction surveys, analyze results, and implement follow-up actions to enhance service quality.
• Document and track facility visits, member communications, and disenrollment activities with accuracy and compliance.
• Provide facility leadership with updated enrollee rosters and ID cards on a monthly basis.

Qualifications & Requirements

• Self-motivated professional with excellent organizational and time-management skills.
• Minimum 2 years’ experience in a healthcare delivery setting serving elderly patients (nursing home experience strongly preferred).
• CNA or LVN certification preferred.
• Active Texas health insurance license preferred, or ability to obtain licensure by meeting education and testing requirements.
• Proven success in healthcare sales or related market experience preferred.
• Strong interpersonal skills, with the ability to listen effectively, communicate clearly, and collaborate across teams.
• Proficient in Microsoft Office and able to maintain accurate digital records.
• Ability to build strong working relationships with facility staff, including nursing, physicians, and administrators.
• Reliable transportation, valid driver’s license, clean driving record, and proof of insurance required.
• Suitable home workspace for administrative tasks.

We are an Equal opportunity employer; We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.

Diversity, Equity and Inclusion are at the heart of Pivot Rehab. We are committed to a culture that respects our differences and values the contribution of all people.