Member Support Specialist

PacificSource Health Plans

. Serve as a resource to members with complex psychosocial issues that create barriers to medical-regimen adherence and optimal health outcomes .

Posted 9/22/2026full-timeRemote • North Carolina • United StatesMid-LevelSenior💰 $35,543 - $56,869 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coordinating healthcare services and community resources to support members with complex psychosocial issues. Proficient in motivational interviewing, case management, and compliance with healthcare regulations.

Highest-signal resume keywords

Case Management ExperienceMotivational InterviewingMedical Terminology KnowledgeMicrosoft Office ProficiencyCommunity Resource Identification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementHealth Insurance KnowledgeData Entry and ReportingAppointment SchedulingMedical Management Software

Soft Skills

Excellent Communication SkillsTeam CollaborationIndependent Work AbilityPresentation Skills

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPointCaseTrakker Dynamo

Industry Keywords

Healthcare CoordinationPsychosocial SupportHIPAA ComplianceQuality Improvement InitiativesCommunity Services

About the role

Key responsibilities & impact

Serve as a resource to members with complex psychosocial issues that create barriers to medical-regimen adherence and optimal health outcomes
Work telephonically and in person to support members
Coordinate with case managers to develop and implement member-specific goals and plans
Educate members about their benefit structures
Use motivational interviewing and patient-engagement techniques to support optimal health outcomes
Identify community resources and make appropriate referrals
Serve as liaison between members and providers/agencies
Identify members for coordination and case management services using claims data and reports
Screen requests for appropriate case-management referrals
Collaborate with the case-management team and participate in case-management/care-coordination meetings
Maintain compliance with state and federal regulations, HIPAA standards, confidentiality, and accurate documentation
Assist with referrals, appointment scheduling, and transportation to medical appointments
Assist members with non-clinical needs during transitions and phases of care
Manage mailing lists and outgoing mailings
Assist with departmental procedures, reports, and projects
Support care management quality measures required by government regulations
Enter and collate data and prepare assigned reports
Participate in requested committees
Make small-group presentations
Participate in quality-improvement initiatives
Perform other duties as assigned

Requirements

What you’ll need

Minimum of three years of experience in community services or healthcare agencies focused on coordination services
Experience in health insurance and delivering group presentations preferred
High school diploma or equivalent required
Knowledge of medical terminology
Proficient in Microsoft Office, including Word, Excel, and PowerPoint
Experience with medical management software, such as CaseTrakker Dynamo
Excellent verbal and written communication skills
Ability to work independently and effectively on a team
Good working knowledge of how to access community resources and the healthcare system
Ability to meet department and company performance and attendance expectations
Ability to read and comprehend written and spoken English
Ability to communicate clearly and effectively
Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing/sorting/filing motions, and lightly lift and carry files and business materials
Ability to travel approximately 20% of the time

Benefits

Comp & perks

Equal opportunity employment
Work-from-home arrangement in North Carolina
Travel required approximately 20% of the time
Ergonomically configured equipment
Participation in quality improvement initiatives
Participation in team, department, company, and community-related committees
At-will employment