Member Support Specialist II

PacificSource Health Plans

. Develop and implement goals and plans with case managers to help members navigate the healthcare system .

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 case management and healthcare coordination, utilizing motivational interviewing and patient-engagement techniques to enhance member outcomes. Proficient in navigating healthcare systems and community resources while ensuring compliance with regulations and maintaining accurate documentation.

Highest-signal resume keywords

Case Management ExperienceMotivational InterviewingHealthcare System NavigationMedical Management SoftwareExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical TerminologyData EntryReport PreparationClaims Data AnalysisAppointment Scheduling

Soft Skills

Team CollaborationIndependent WorkPresentation SkillsProblem-SolvingInterpersonal Skills

Tools & Technologies

Microsoft OfficeCaseTrakker Dynamo

Industry Keywords

Healthcare CoordinationCommunity ResourcesHIPAA ComplianceQuality MeasuresBenefit Structure

About the role

Key responsibilities & impact

Develop and implement goals and plans with case managers to help members navigate the healthcare system
Educate members on understanding and working within their benefit structure
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 from internal and external sources
Collaborate with the case management team and participate in case management/care coordination meetings
Ensure compliance with state and federal regulations, HIPAA standards, and confidentiality requirements
Maintain accurate and timely 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
Assist care management in meeting government-regulated quality measures
Enter and collate data and prepare assigned reports
Participate in committees and make small-group presentations
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 stoop and bend
Ability to sit and/or stand for extended periods
Ability to perform repetitive typing, sorting, and filing
Ability to lightly lift and carry files and business materials
Ability to read and comprehend written and spoken English
Ability to communicate clearly and effectively
Approximately 20% travel required

Benefits

Comp & perks

Telephonic and in-person member support
Work inside in a general office setting with ergonomically configured equipment
Equal opportunity employment
Participation in quality improvement initiatives
Participation in team, department, company, and community-related committees