Job Title

Member Services Specialist Location: Santa Barbara, CA (Hybrid)Compensation: $36.76 - $53.31 per hour + full benefitsAbout the Organization:Our client is a mission-driven healthcare organization committed to improving access and quality of care for underserved populations across the Central Coast. With a strong culture of service, collaboration, and innovation, they deliver compassionate support and reliable health plan services for their members and provider partners.The Opportunity:The Member Services Specialist will serve as the first point of contact for health plan members, providing proactive, high-quality support via phone and other communication channels. This role is essential in helping members understand their benefits, navigate the healthcare system, and access necessary services. Its a great fit for someone who enjoys making a daily impact, thrives in a fast-paced environment, and brings empathy and efficiency to every interaction.Key Responsibilities:Deliver robust customer service in a high-volume call center, addressing questions related to Medicare, Medi-Cal, supplemental benefits, referrals, claims, providers, and moreEducate members on plan benefits, co-pays, provider networks, and health resourcesAssist with scheduling, interpreter coordination, and navigation of health-related documentsConduct outbound outreach such as new member orientation and coverage restoration supportServe as a liaison between members and departments like Care Coordination, Pharmacy, and Quality ManagementTriage continuity of care requests and coordinate with external agencies and community partnersHandle grievance and appeal intake, and document all contact and follow-up activitySupport compliance and quality initiatives as neededWhat Were Looking For:1–3 years of experience in healthcare customer service, preferably in a Medicare Advantage or Medi-Cal/D-SNP environmentKnowledge of healthcare systems and benefits navigation; prior use of systems such as QNXT, CalSAWS, MedHok a plusBilingual in Spanish preferred.Clear communicator who can explain complex benefits and procedures in a compassionate and accessible wayStrong organizational and time management skills; able to juggle multiple tasks with attention to detailFlexible and comfortable working rotating shifts between 8am–8pm, 7 days/week (standard 40-hour workweek)Comfortable collaborating across departments and taking initiative to ensure a positive member experience.Traits That Thrive in This Role:Mission-driven and people-firstCalm under pressure and solutions-orientedDetail-focused with strong follow-throughStrong interpersonal instincts and a desire to help othersAdaptable to changing needs, systems, and schedulesAdditional Requirements:Must be able to travel to the office as needed (hybrid schedule)Must possess a valid driver’s license and maintain a clean driving recordMust be able to sit at a computer for extended periods and work in a standard office environment