Medicaid Member Advocate (West Virginia)

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 SummaryThe Medicaid Member Advocate is a key position in the MHP (Mental Health Professional) Promise Agreement, which is a specialized managed care program in West Virginia designed for children in foster care, kinship care, and adoptive care, aligned with Aetna Better Health of West Virginia as its single managed care organization.Job duties include:Responsible for interacting with the population and ensuring that our members are referred and connected to appropriate resources.Collaborating with Care Management Director, Mountain Health Promise care coordinators, System of Care Administrators, and the SNS (Socially Necessary Services) Liaison.Providing member support related to enrollment, access, and continuity of care issues.Supporting members throughout any grievances of appeal activities.Assisting members in obtaining materials in alternative formats, as applicable.Supporting and addressing needs of children and youth in foster care with educational needs by collaborating with transition specialists, care managers, and others that provide a supportive transition.Serving as an advocate for members by creating a bridge between them and community programs or resources.Supporting our youth's socio-psychological needs (such as security, love, approval, independence and/or achievement), specifically through individual support systems or goals, in an effort to help youth achieve support and independence.Supporting the transitional-aged youth with ensuring socio-psychological needs are met appropriately.Ensuring the IEP (Individualized Education Program) credits and needs are supported for a smooth transition from residential to community.Performing other duties as needed.Required Qualifications3-5 years of experience in healthcare, specifically working with low-income and foster care population.Must reside in West Virginia.Willingness to travel up to 10% within the state of West Virginia.Preferred Qualifications5+ years of experience working in foster care or low-income populations.Proficiency documenting needs, efforts, and outcomes in tracking systems/CRMs (such as QuickBase) and managing multiple member cases.Strong verbal and written communication skills.Culturally sensitive, trauma‐informed, and empathetic approach when interacting with members and families.Excellent organization and time‐management skills, with the ability to prioritize urgent needs.Collaborative mindset and ability to work effectively with multidisciplinary teams and community partners.Problem‐solving skills to navigate complex legal, educational, welfare, and housing systems.Reliability and consistency in attending required meetings/rounds and completing documentation.Bachelor Degree in Social Work, Education or Counseling.EducationBachelor's Degree.Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $91,800.00This 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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 04/02/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.