Member Service Guide – Care Guide

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver outstanding support to members by addressing inquiries with care and precision.

• Assist with locating providers, scheduling and rescheduling appointments, changing primary care providers, facilitating onboarding visits, and connecting members to the appropriate care teams and resources.

• Utilize established protocols and clinical tools to assist members experiencing symptoms or concerning lab results.

• Manage medication refill requests and organize follow-up care.

• Inform members about plan benefits, Devoted Medical programs, enrollment opportunities, pharmacy benefits, Medicaid/LIS programs, and additional resources.

• Ensure timely, thorough, and precise documentation is maintained.

• Work collaboratively with Care Advocates, other Care Guides, Care Pathway Guides, and clinical staff to address member requirements.

• Engage in team meetings, training sessions, and process improvements.

• Adjust to shifting priorities, communication methods, and operational processes.

⛳️ Requirements

• Demonstrated capability to independently manage complex member requirements, apply established protocols, and facilitate resolution across various teams and stakeholders.

• Previous experience in a Tier 2 support position is advantageous for internal candidates.

• Proficient in aiding members with appointment scheduling, provider selection, benefits navigation, clinical order follow-up, and healthcare service coordination.

• Comfortable working within established protocols and escalation processes while assisting members with urgent healthcare needs.

• Excellent written and verbal communication skills across phone, chat, and digital platforms.

• Skilled in recognizing member needs, linking information across systems, and proactively eliminating obstacles to care.

• Capable of assessing situations, adhering to established protocols, and determining the appropriate next steps.

• Exhibits compassion, patience, and professionalism when assisting members with healthcare-related issues.

• Ability to collaborate effectively with clinical teams, providers, and cross-functional partners.

• Adaptable in a fast-paced environment with changing priorities and workflows.

• Must be reliable and capable of working evenings, weekends, and holidays as needed by the business.

• Strong internet connection and a secure, private workspace are required.

🏝️ Benefits

• Employer-sponsored health, dental, and vision insurance with low or no premiums.

• Generous paid time off policy.

• Monthly stipend of $100 for mobile or internet expenses.

• Stock options available for all employees.

• Bonus opportunities for all roles, excluding Director and above.

• Parental leave program.

• 401K program.