ACCESS Member Services Specialist

Vaya Health

. Conduct telephonic screenings and collect demographic information .

Posted 9/30/2026full-timeRemote • North Carolina • United StatesJuniorMid-Level💰 $54,007 - $65,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in mental health and substance abuse services, with a strong understanding of person-centered and recovery-oriented philosophies. Proficient in utilizing complex telephone and computer systems for effective communication and documentation.

Highest-signal resume keywords

Qualified Professional CertificationMental Health Services ExperienceSubstance Abuse Services ExperienceKnowledge of Social Work PrinciplesAbility to Document Information Electronically

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Telephonic ScreeningDemographic Information CollectionEligibility ReviewAppointment SchedulingCall DocumentationRisk Indicator IdentificationWarm TransfersService-System MonitoringKnowledge of Behavioral Health PrinciplesKnowledge of Recovery Philosophies

Soft Skills

Clear CommunicationEffective Relationship BuildingProfessional InteractionEthical ResponsivenessCustomer Service Orientation

Tools & Technologies

Complex Telephone SystemsComputer SystemsElectronic Documentation Systems

Certifications & Qualifications

Qualified Professional CertificationHIPAA Compliance Training

Industry Keywords

Community Mental Health CenterLME/MCO OperationsSocial Determinants of HealthNorth Carolina Medicaid ServicesDevelopmental DisabilitiesSubstance Abuse DisordersGovernmental Community ResourcesUtilization Management

About the role

Key responsibilities & impact

Conduct telephonic screenings and collect demographic information
Provide callers with choices among available providers and link them to appropriate services
Link callers to licensed clinicians for urgent or emergent services when needed
Review and confirm member and recipient eligibility
Schedule appointments within established access-time standards
Handle customer-service calls regarding enrollment, service access, referrals, Social Determinants of Health needs, provider changes, and general information
Provide information about Vaya Partners, its provider network, community resources, and North Carolina Medicaid services
Identify risk indicators and make immediate referrals to Member and Recipient Services Clinicians
Resolve caller questions when possible or explain resolution processes and timeframes
Complete warm transfers and linkages to appropriate parties
Complete call notes, forms, reports, and other electronic documentation during or immediately after calls
Monitor service-system trends and report gaps and needs to management or Provider Network Development staff
Adhere to the NCMT Call Grading Rubric and deliver person-centered, recovery-oriented customer service
Assist with specialized ACCESS Call Center projects and perform other assigned duties

Requirements

What you’ll need

Bachelor’s degree in a Human Services field and at least two years of experience working with adults or children with serious psychiatric, chemical dependence, or developmental disability in a community mental health center or similar setting, OR bachelor’s degree from an accredited college or university and at least four years of such experience
Must be qualified as a Qualified Professional according to 10A NCAC 27G .0104
Experience providing mental health, substance abuse services, or intellectual/developmental disabilities
Knowledge of social work principles, techniques, and practices
Knowledge of behavioral health principles and complex treatment and services provision
Knowledge of person-centered and recovery philosophies
Familiarity with mental health, developmental disability, and substance abuse disorders
Knowledge of governmental and private community organizations and resources
Knowledge of laws, regulations, and policies governing LME/MCO operations, human services, and utilization management
Ability to use complex telephone and computer systems and multiple technology systems concurrently during live calls
Ability to document information electronically and complete call notes, forms, reports, and other documentation at the time of call
Ability to communicate clearly and concisely orally and in writing
Ability to establish effective working relationships with community members and provider agency staff
Ability to interact professionally and effectively with upset individuals and those who disagree
Ability to remain professionally responsive in an ethical and sensitive manner
Required confidentiality and compliance training regarding HIPAA, 42 CFR Part 2, and applicable state laws; must sign a confidentiality statement
Must reside in North Carolina or within 40 miles of the North Carolina border

Benefits

Comp & perks

Overtime compensation eligibility
Remote, home-based work
Monday–Friday schedule
40-hour work week
Customer Satisfaction Survey participation at call close (service-quality practice)