Member Experience Vendor Specialist

Imperial Health Holdings; Pasadena (CA); Sur place; USD 29 000 - 33 000; Plein temps

Résumé du poste

Imperial Health Holdings in Pasadena, CA seeks a Member Experience Vendor Specialist to support members with questions, complaints, and service issues involving health plan vendors. You will coordinate with vendors and internal teams to address concerns and ensure timely resolution while maintaining member confidentiality.

The role covers transportation, fitness, vision, dental, OTC, Grocery, Flex, Reward, and other vendor-administered services.

Qualifications

• Experience in health plan member services or a healthcare setting preferred.
• Strong communication, organization, problem-solving, and follow-up skills.
• Ability to handle sensitive concerns professionally and maintain accurate records.
• Familiarity with health plan benefits and standard office/case management systems preferred.

Responsabilités

• Serve as a contact for vendor-related member concerns, complaints, and service requests.
• Coordinate with transportation and other vendors to resolve access to benefits.
• Assist members with access to fitness, vision, dental, OTC, and other vendor benefits.
• Investigate eligibility issues and coordinate with vendors to resolve discrepancies.
• Document member contacts and outcomes in designated systems.
• Provide status updates and timely follow-up through resolution.
• Identify recurring issues and share trends with management.

Connaissances

Customer service

Vendor coordination

Communication

Problem solving

Formation

High school diploma

Description du poste

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Appeals and Grievances Pasadena, CA, US

Salary Range: $21.00 To $24.00 Hourly

Job Description

Department: Member Experience

Reports to: Sr. Manager Member Experience

Position Summary

The Member Experience Vendor Specialist supports members with questions, complaints, and service issues involving health plan vendors. The specialist works with members, vendors, and internal departments to coordinate services, address concerns, and follow through on outstanding issues. This role supports a positive member experience across transportation, fitness, vision, dental, OTC, Grocery, Flex, Reward, and other vendor-administered services.

Essential Duties and Responsibilities

• Serve as a point of contact for vendor-related member concerns, complaints, and service requests.
• Coordinate with transportation vendors and internal teams to verify required authorizations and address ride scheduling concerns, delays, cancellations, and other service issues.
• Assist members with access and service concerns involving fitness, vision, dental, OTC, Grocery, Flex, Reward, and other vendor benefits.
• Investigate eligibility issues and coordinate with vendors and internal departments to resolve discrepancies affecting access to benefits and services.
• Research concerns, gather relevant information, and work with the appropriate vendor or department to support timely resolution.
• Provide clear status updates and follow up on pending requests through resolution or appropriate handoff.
• Document member contacts, vendor communications, actions taken, and outcomes accurately in designated systems.
• Recognize and promptly route grievances, appeals, urgent concerns, and unresolved issues to the appropriate team under established procedures.
• Identify recurring vendor service concerns and share trends and improvement opportunities with management.
• Support department goals for timeliness, quality, productivity, and member satisfaction while protecting member confidentiality.
• Perform other related duties as assigned.

Qualifications

• High school diploma or equivalent
• Experience in health plan member services, Customer service, Vendor coordination, or a related healthcare setting preferred.
• Strong communication, organization, problem-solving, and follow-up skills.
• Ability to handle sensitive concerns professionally, manage multiple priorities, and maintain accurate records.
• Familiarity with health plan benefits and standard office and case management systems preferred.