Member Support Specialist

Who you are

• The ideal candidate brings advanced critical thinking, emotional intelligence, and the ability to tackle advanced issues while ensuring members and RDs feel heard, supported, and respected
• Advanced Critical Thinker: Ability to assess complex, ambiguous situations and determine the best course of action
• Agile in Communication: Strong written and verbal communication skills with the ability to tailor tone and messaging across audiences
• Sound Judgment: Trusted to make decisions on sensitive accommodation and escalation cases
• De-escalation & Mediation Minded: Proven ability to manage high-emotion interactions and drive resolution
• Empathetic with Authority: Can create a supportive experience while maintaining control and direction of the conversation
• Detail Orientated: Strong documentation and compliance mindset, especially with sensitive or regulated processes
• Technically Proficient: Established acumen for technically intricate situations, and capable of communicating effectively with product and engineering teams
• Reliable high speed internet access with minimum speeds of roughly 100 Mbps download and 20 Mbps upload
• A completely private, secure, and quiet workspace
• 1–3+ years in member/patient support, escalations, grievances, or case management
• Experience working with health plans, healthcare systems, or regulated environments preferred
• Demonstrated experience handling complex escalations or complaint resolution
• Experience working in technically complex roles

What the job involves

• This role serves as the final point of contact for complex member issues, including health plan grievances, RD grievances, and advanced member account support and food benefits escalations
• This individual is responsible for resolving highly sensitive situations that require strong judgment, cross-functional coordination, and nuanced communication with members, health plans, and internal stakeholders
• Own and resolve high-priority, complex, or sensitive member escalations end-to-end
• Own all escalations and grievances relating to RDs end to end, and collaborate with the Clinical Operations team to manage and document these effectively
• Investigate RD reports of member behavior and safety concerns
• Serve as the “last line” point of contact for unresolved member concerns in their scope
• Investigate escalated or complex member and internal requests relating to member profile and food benefit issues
• Ensure timely, compliant, and well-documented resolution of all escalations
• Communicate professionally and clearly with health plans, providers, and external partners
• Adapt communication style based on audience (members, executives, clinical and member support teams, partners)
• Translate complex issues into actionable insights for internal stakeholders
• Manage and escalate benefit and account issues to the engineering and product team, and manage ongoing requests and projects with these groups
• Lead de-escalation efforts with empathy, professionalism, and control
• Maintain communication standards by monitoring the quality of communication around benefit programs and account issues between member support and members
• Ensure internal and external resources outlining benefits programs are current and accurate
• Make independent, high-stakes decisions within established guidelines
• Identify when to escalate issues further vs. resolve directly
• Recognize patterns and recommend improvements to reduce future escalations
• Success in this role looks like:
• Complex escalations are resolved efficiently and thoughtfully
• Members and RDs feel heard and supported—even in difficult situations
• Health plan and partner communications are clear, professional, and effective
• Trends in escalations are identified and fed back to improve the overall member experience
• Emerging product and engineering issues are escalated in a timely manner, and ongoing issues are contributed to and closely monitored

Benefits

• Unlimited PTO
• Flexible working hours
• Flexible working location
• Paid health insurance
• 401k, bonus & stock options