Member Service Guide: Care Guide

Job description

Job Description A bit about this role: As a Member Service Guide, Care Guide (CG) you are the welcoming face and trusted voice of Devoted Medical, playing an essential role in transforming how our members experience healthcare. In this high-impact position, you will serve as the primary front door for members, guiding them through appointments, clearing up benefit inquiries, and solving care coordination needs with empathy and clarity. Working primarily across phone, and occasionally digital channels, you’ll connect members to the right care at the exact moment they need it most—turning complex healthcare navigation into a compassionate, empowering experience. Responsibilities and Impact will include: Provide Exceptional Member Support: Deliver world-class service by promptly responding to member inquiries with empathy, accuracy and a commitment to resolving needs during the first interaction whenever possible Coordinate Care Navigation & Access: A ssist members with provider searches, appointment scheduling and rescheduling, PCP changes, Devoted Medical onboarding visits and connection to appropriate care teams and resources. Clinical Care Coordination: Applies established protocols and clinical tools to support members presenting with symptoms or critical lab results; processes medication refill requests, coordinates follow-up care, and ensures timely communication of health care updates to members. Deliver Benefit and Program Education : Educate members on plan benefits, Devoted Medical programs, Enrollment opportunities, pharmacy benefits, Medicaid/LIS programs and other available resources. Maintain Accurate Documentation : Ensure timely complete and accurate documentation to support continuity of care and reporting accuracy. Collaborate Across Teams: Partner with CAs, Other CG's, Care Pathway Guides and clinical staff to close loops and resolve member needs efficiently. Contribute to Team & Process Improvement: Participate in team meetings, learning opportunities, and workflow enhancements that improve member outcomes and operational effectiveness. Adapt to Evolving Business Needs: Demonstrate flexibility in supporting changing priorities, communication channels, and operational workflows. Required skills and experience: Advanced Problem Resolution: Proven ability to independently navigate complex member needs, apply established protocols, and coordinate resolution across multiple teams and stakeholders. ( Prior experience in a Tier 2 support role a plus for internal candidates.) Healthcare Navigation & Care Coordination: Ability to support members through appointment scheduling, provider selection, benefit navigation, clinical order follow-up, and coordination of healthcare services. Protocol Adherence: Comfort working within established protocols and escalation pathways while supporting members with time-sensitive healthcare needs. Digital Communication Proficiency: Strong written and verbal communication skills with the ability to effectively flex and help members across phone, chat, and digital platforms. Active Listening & Member Advocacy : Ability to identify member needs, connect information across systems, and proactively remove barriers to care. Critical Thinking & Problem Solving: Ability to evaluate situations, follow established protocols, and determine appropriate next steps to support member needs. Empathy & Emotional Intelligence: Demonstrates compassion, patience, and professionalism when supporting members through healthcare-related concerns. Collaboration & Teamwork: Works effectively with clinical teams, providers, and cross functional partners to coordinate member care and achieve positive outcomes. Adaptability & Reliability: Thrives in a dynamic environment with evolving priorities and workflows while maintaining strong performance and accountability. Schedule Flexibility: Must be dependable and able to work evenings, weekends, and holidays as business needs require. Remote Work Environment: Strong internet connection and a secure, private workspace Hours of Operation & Scheduling Expectations: Our Member Services operation runs extended hours to ensure members can reach us when they need us. Please Note: Specific schedules are finalized and discussed at the time of a potential offer and are offered on a first come first serve basis. The hours outlined below represent our overall call center coverage, so it is important to understand that a schedule within any of these operational windows may be required of you to meet business and member needs. Operational Hours by Season: April – September: Monday – Friday (8:00 AM – 2:00 AM ET) · Saturday (8:00 AM – 11:00 PM ET) October – November: Sunday – Saturday (8:00 AM – 2:00 AM ET) November – March: Sunday – Saturday (8:00 AM – 1:00 AM ET) Salary : $22 - 25 / hour The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience. Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.