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 North Carolina's Medicaid system and the ability to effectively communicate and document information. Proficient in utilizing complex telephone and computer systems to manage client interactions and referrals.

Highest-signal resume keywords

Qualified Professional CertificationMental Health Services ExperienceKnowledge of North Carolina MedicaidBehavioral Health PrinciplesPerson-Centered Recovery Philosophies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Telephonic ScreeningEligibility ReviewAppointment SchedulingRisk Indicator IdentificationDocumentation in Electronic SystemsCustomer ServiceReferral ManagementKnowledge of Social Work PrinciplesKnowledge of Substance Abuse ServicesKnowledge of Developmental Disabilities

Soft Skills

Clear Oral CommunicationWritten CommunicationProfessional InteractionProblem-SolvingCustomer Satisfaction Focus

Tools & Technologies

Electronic Documentation SystemsComplex Telephone SystemsMultiple Technology Systems

Certifications & Qualifications

Qualified Professional Certification

Industry Keywords

Human ServicesCommunity Mental HealthSocial Determinants of HealthUtilization ManagementNorth Carolina MedicaidBehavioral HealthSubstance Abuse DisordersDevelopmental Disabilities

About the role

Key responsibilities & impact

Conduct telephonic screenings and collect demographic information
Review and confirm member and recipient eligibility
Offer provider choices based on consumer requests and service needs
Schedule appointments within established access time standards
Link members with contracted providers for clinical assessments
Identify risk indicators and make immediate referrals to Member and Recipient Services Clinicians
Handle customer service calls regarding enrollment, services, referrals, provider changes, Social Determinants of Health needs, and general information
Provide information about Vaya Partners, its provider network, community resources, and North Carolina Medicaid services
Complete warm transfers and link callers to appropriate parties, providers, vendors, community organizations, and legal guardians
Document call notes, forms, reports, and other required information in electronic systems
Report service-system gaps and needs to managers or Provider Network Development staff
Offer Customer Satisfaction Surveys and adhere to the NCMT Call Grading Rubric
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 a 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 service provision
Knowledge of person-centered and recovery philosophies
Familiarity with mental health, developmental disability, and substance abuse disorders
Knowledge of North Carolina’s Medicaid system
Knowledge of laws, regulations, and policies governing 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 required documentation at the time of the call
Ability to communicate clearly orally and in writing
Ability to interact professionally with upset or disagreeing individuals
Must reside in North Carolina or within 40 miles of the North Carolina border

Benefits

Comp & perks

Overtime compensation eligibility
Extensive training on customer service skills, insurance plans, applicable confidentiality laws, and related systems
Equal opportunity employer