Member Service Representative

Remote (United States)

Job Details

Location: United States

Workplace: Remote

Employment Type: Full-time

Experience: 1–3+ years in member services, care navigation, eligibility/referrals, community-based services, healthcare call center, or a similar member-facing role

Core Areas: Member Services, Case Management, Care Navigation, Housing Support, Member Outreach, Salesforce CRM, Community Resource Referrals, Documentation and Follow-up Management

Compensation: $50,000–$60,000 annually

Schedule: Initially Monday–Friday, with coverage aligned to Eastern and Pacific time zones. Schedule adjustments may include occasional evenings and, over time, weekends, depending on business needs and member caseload coverage.

About the Role

This Member Service Representative (Remote - United States) position focuses on providing direct member support, managing an assigned caseload, and coordinating housing-related services for individuals experiencing housing instability. The role serves as the primary point of contact for members, conducts structured check-ins, identifies barriers, coordinates next steps, and maintains consistent follow-up to support member engagement, satisfaction, and retention.

Responsibilities combine member services, care navigation, housing coordination, and operational case management. The position uses Salesforce daily to document interactions, manage outreach, monitor member progress, and prioritize follow-ups. The role involves working with Medicaid members, individuals facing housing insecurity, internal care teams, local providers, and community-based organizations. Success requires strong phone communication, accurate documentation, effective caseload management, and the ability to address complex member needs in a structured, metrics-driven environment. The position reports to the SVP of Clinical Operations.

What You'll Do

• Manage an assigned caseload of members, serving as their primary point of contact throughout the housing support process.
• Conduct structured weekly check-ins and additional outreach as needed to assess progress, identify outstanding needs, address barriers, and maintain member engagement.
• Develop practical next steps with members and maintain accountability through consistent communication, follow-up, and progress tracking.
• Coordinate housing-related activities, including gathering required information, assisting with applications, communicating with partners, and supporting progress toward housing placements.
• Connect members with appropriate community resources, including food assistance programs, local community-based organizations (CBOs), and other support services.
• Use Salesforce CRM daily to document member interactions, track outreach activities, update case status, manage tasks, and schedule follow-ups.
• Organize daily work using workflow queues, member risk levels, urgency, and service priorities to support timely outreach and resolution.
• Identify and escalate barriers involving documentation, communication, member readiness, or access to services to help resolve issues and maintain progress.
• Coordinate with internal teams, local providers, and external partners to facilitate service handoffs, communicate next steps, and provide members with consistent information.
• Maintain accurate, detailed member records and track outcomes to support operational reporting, service quality, and continuous improvement.
• Monitor assigned follow-up activities and service-level expectations to ensure consistent member support across the caseload.
• Provide feedback on workflows, communication templates, and member support resources to improve service efficiency, clarity, and the overall member experience.

Qualifications

Required Experience

• 1–3+ years of experience in member services, care navigation, eligibility and referrals, community-based services, a healthcare call center, or a comparable fast-paced, member-facing position.
• Experience supporting Medicaid members and/or individuals experiencing homelessness or housing insecurity.
• Experience managing an assigned workload or caseload, organizing priorities, and maintaining timely follow-up across multiple member needs.
• Experience working in a structured, metrics-driven environment with defined activity expectations and follow-up service-level agreements (SLAs).

Required Skills

• Strong telephone communication skills, including the ability to establish rapport quickly, communicate clearly, and guide conversations toward actionable next steps.
• Ability to provide consistent member support through structured check-ins, outreach, follow-up, and coordination of services.
• Strong caseload management and organizational skills, with the ability to prioritize member needs, manage competing tasks, and maintain accountability for outstanding actions.
• Proficiency in accurate case documentation, interaction tracking, and task management using Salesforce or a comparable CRM or workflow management system.
• Ability to work effectively with workflow queues, performance metrics, activity expectations, and follow-up deadlines.
• Strong attention to detail when recording member information, updating case status, and maintaining documentation for reporting and service coordination.
• Ability to identify service barriers, assess urgency, escalate issues appropriately, and coordinate practical next steps with members and service partners.
• Ability to support individuals facing complex circumstances with empathy, professional boundaries, clear communication, and a focus on measurable progress.

Preferred Qualifications

• Experience supporting housing navigation, housing assistance, placement coordination, or related community support programs.
• Relevant professional certifications or licenses, such as HUD certification, Community Health Worker (CHW) certification, Master of Social Work (MSW), or Licensed Clinical Social Worker (LCSW). These credentials are preferred but not required.
• Familiarity with housing instability, social determinants of health, and challenges affecting access to housing and community services.
• Spanish language fluency.

Benefits

• Medical insurance coverage.
• Dental insurance coverage.
• Vision insurance coverage.
• Paid time off.
• Company holidays.