Member Care Coordinator

Calibrate

. Execute critical clinical administrative workflows to resolve readiness barriers and accelerate members toward provider review and medication access .

Posted 11/9/2026full-timeRemote • United StatesJuniorMid-Level💰 $20 - $22 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing complex medication access workflows, including prior authorizations and appeals, while ensuring effective communication with members and healthcare providers. Proficient in utilizing case management systems and collaborating across departments to enhance member care.

Highest-signal resume keywords

Medication Access Workflow ManagementPrior Authorization SubmissionCase Management Systems (Zendesk, EHR)Customer Service in HealthcareComplex Process Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Document PreparationPrior Authorization InvestigationPharmacy-Level Rejection ResolutionData Gathering and CoordinationOperational Trend Reporting

Soft Skills

Exceptional Verbal CommunicationWritten Communication SkillsProfessionalism and EmpathyProblem-SolvingCollaboration

Tools & Technologies

ZendeskElectronic Health Records (EHR)PA/E-Prescribing Platforms

Certifications & Qualifications

Certified Medical Assistant (CMA)Registered Medical Assistant (RMA)

Industry Keywords

HealthcarePharmacy Benefit Manager (PBM)Patient AdvocacyHigh-Volume Customer ServiceCall Center Experience

About the role

Key responsibilities & impact

Execute critical clinical administrative workflows to resolve readiness barriers and accelerate members toward provider review and medication access
Prepare clinical documents and proactively triage member needs for specialty support
Facilitate structured handoffs of critical information to Clinical and Coaching teams
Participate in cross-functional meetings and collaborate with other departments to improve member care
Identify and report recurring systemic issues, submission errors, and operational trends
Own the end-to-end medication access workflow, including gathering clinical data, coordinating with clinicians, submitting complex prior authorizations, investigating denials, documenting appeals, and managing final determinations and overrides
Contact members by phone and secure message to request information and explain complex prior authorization status changes or delays
Call insurance carriers, PBMs, and pharmacies to obtain case statuses, track documentation, and secure approvals
Log communications, investigation notes, and prior authorization statuses accurately in case management systems such as Zendesk and MJD
Resolve pharmacy-level rejections and troubleshoot insurance issues preventing successful claims processing

Requirements

What you’ll need

Completion of a formal medical assisting program is highly valued
National certification such as Certified Medical Assistant (CMA) awarded by the AAMA or Registered Medical Assistant (RMA) awarded by the AMT is preferred
Familiarity with case management systems such as Zendesk, Electronic Health Records (EHR), and PA/e-prescribing platforms is highly desirable
2+ years of high-volume customer service, call center, or patient advocacy experience, preferably in a healthcare, pharmacy, or PBM setting
Demonstrated experience managing complex, multi-step processes requiring follow-up and persistence
Exceptional verbal and written communication skills
Ability to handle challenging, escalated calls and messages with professionalism and empathy

Benefits

Comp & perks

Generous paid time off policy, including multiple paid company holidays, wellness days, and floating holidays
Medical, dental, and vision benefit options
Calibrate-funded disability and basic life insurance
Wellness programs, including a complimentary Headspace membership and therapy through Headspace Care
Employee Assistance Program through Principal
Remote-first ways of working, with flexibility to work from any state
Competitive paid parental leave program