**Job Description** **Job Summary** Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials. **Knowledge/Skills/Abilities** • Maintains confidential telephone line to provide direct assistance to Members and/or family members who are unable to resolve their issues or complaints individually. Serves as an advocate in working with providers, regulatory agencies, outside agencies, co-workers and other departments as appropriate. Conducts in person meetings with Members and/or family members as appropriate. Logs all cases in a database. • Assists members in the complaint and appeal process. Determines the nature of the member's needs or problem; informs members of their rights in the complaints and appeals process; and advises/refers as appropriate for investigation and resolution. • Conducts focus groups in service delivery area as needed to ensure member needs are being addressed. • Educates members on covered services available to them, including preventive services. • Participates in annual member complaints and appeals training with health plan, including the member advocate/engagement role.. **Job Qualifications** **Required Education** High School diploma. **Required Experience** 2 years experience in customer service, consumer advocacy, and/or health care systems. Experience conducting intake, interviews, and/or research of consumer or provider issues. Basic understanding of managed healthcare systems and mental health issues. **Required License, Certification, Association** Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. **Preferred Education** Associate's or Bachelor's Degree in Social Work, Human Services or related field. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $14.9 - $29.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.