Member Support Specialist II

PacificSource Health Plans

. Serve as a resource to members with complex psychosocial issues affecting medical-regimen adherence and health outcomes .

Posted 11/12/2026full-timeRemote • Georgia • 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, utilizing motivational interviewing and patient engagement techniques to enhance member support and adherence. Proficient in maintaining compliance with regulations and delivering effective communication in both verbal and written forms.

Highest-signal resume keywords

Healthcare CoordinationMotivational InterviewingMedical TerminologyMicrosoft Office ProficiencyCommunity Resource Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Healthcare CoordinationMedical TerminologyData EntryReport PreparationCase Management Software

Soft Skills

Excellent Communication SkillsTeam CollaborationIndependent Work Ability

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPointCaseTrakker Dynamo

Industry Keywords

Community ServicesHealthcare AgenciesHIPAA CompliancePatient EngagementClaims Data Analysis

About the role

Key responsibilities & impact

Serve as a resource to members with complex psychosocial issues affecting medical-regimen adherence and 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 structure
Use motivational interviewing and patient-engagement techniques
Identify community resources and make 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 care-coordination meetings
Maintain compliance with state and federal regulations, HIPAA, and confidentiality requirements
Maintain accurate and timely documentation
Assist with referrals, appointment scheduling, and transportation to medical appointments
Support members with non-clinical needs during transitions and phases of care
Manage mailing lists and outgoing mailings
Assist with departmental procedures, reports, projects, and quality measures
Enter and collate data and prepare reports
Participate in committees and make small-group presentations
Meet department and company performance and attendance expectations
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
Proficiency 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 accessing community resources and the healthcare system
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 and filing, and lift and carry files and business materials
Travel approximately 20% of the time

Benefits

Comp & perks

Equal opportunity employment
Work-from-home arrangement
Ergonomically configured equipment
Participation in quality improvement initiatives
Participation in team, department, company, and community-related committees
At-will employment