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Member Support Specialist, Escalations & Grievances

Member Support Specialist, Escalations & Grievances

F
FoodsmartHealthcare support
Remote (US)Full-TimeJunior
Salary$40,000 - $46,000 a year; Base Salary Range: $40,000 - 46,000 + potential $8,000 annual bonus
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Job Details

Experience
1–3+ years in member/patient support, escalations, grievances, or case management.

Requirements

  • Have 1–3+ years of experience in member or patient support, escalations, grievances, or case management.
  • Demonstrate experience handling complex escalations or complaint resolution.
  • Have experience working in technically complex roles.
  • Bring strong written and verbal communication skills and adapt tone and messaging to different audiences.
  • Demonstrate critical thinking and sound judgment in complex, ambiguous, or sensitive cases.
  • Be able to manage high-emotion interactions and de-escalate concerns.
  • Maintain detailed documentation and a compliance mindset for sensitive or regulated processes.
  • Have reliable high-speed internet access of roughly 100 Mbps download and 20 Mbps upload.
  • Maintain a completely private, secure, and quiet workspace.
  • Experience working with health plans, healthcare systems, or regulated environments is preferred.

Responsibilities

  • Own and resolve high-priority, complex, or sensitive member escalations end-to-end.
  • Manage RD escalations and grievances, collaborating with Clinical Operations to document and resolve them.
  • Investigate RD reports of member behavior and safety concerns.
  • Investigate complex member and internal requests involving member profiles and food benefits.
  • Communicate with health plans, providers, external partners, members, and internal stakeholders.
  • Escalate benefit and account issues to product and engineering teams and manage ongoing requests and projects with those teams.
  • Lead de-escalation efforts and monitor the quality of communications about benefit programs and account issues.
  • Keep internal and external benefit-program resources current and accurate.
  • Make decisions within established guidelines, determine when further escalation is needed, and recommend improvements based on escalation patterns.
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$40,000 - $46,000 a year; Base Salary Range: $40,000 - 46,000 + potential $8,000 annual bonus
Apply Now