Member Service Guide (Care Guide)

Devoted Health; Waltham (MA); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Comprehensive health plan

401K retirement plan

Generous vacation and holiday time

Lyra mental health resources

Stock options

Job summary

Devoted Medical is seeking a Member Service Guide to be the welcoming face and trusted voice for members, guiding them through appointments, benefit inquiries, and care coordination with empathy and clarity.

You will work across phone and digital channels, connecting members to the right care at the right time, delivering world-class service and ensuring timely communication of health updates and program education.

Qualifications

• Excellent communication and empathy when assisting members.
• Experience in customer service or care navigation is preferred.
• Ability to work evenings, weekends, and holidays as business needs require.

Responsibilities

• Welcome members and guide them through appointments and benefit inquiries.
• Coordinate care navigation, scheduling, and onboarding as needed.
• Assist with provider searches, scheduling, and care coordination.
• Apply protocols to member symptoms, refill requests, and follow-up care.
• Educate members on plan benefits, programs, and pharmacy support.
• Maintain accurate documentation to support continuity of care.
• Collaborate with clinical teams to resolve member needs efficiently.
• Participate in team meetings and process improvements.
• Adapt to evolving priorities and workflows while maintaining accountability.
• Communicate effectively across phone, chat, and digital platforms.

Skills

Empathy

Active listening

Digital communication

Problem solving

Collaboration

Adaptability

Job description

• As a Member Service Guide, Care Guide (CG) you are the welcoming face and trusted voice of Devoted Medical, playing an essential role in transforming how our members experience healthcare. In this high-impact position, you will serve as the primary front door for members, guiding them through appointments, clearing up benefit inquiries, and solving care coordination needs with empathy and clarity
• Working primarily across phone, and occasionally digital channels, you’ll connect members to the right care at the exact moment they need it most—turning complex healthcare navigation into a compassionate, empowering experience
• Provide Exceptional Member Support: Deliver world-class service by promptly responding to member inquiries with empathy, accuracy and a commitment to resolving needs during the first interaction whenever possible
• Coordinate Care Navigation & Access: Assist members with provider searches, appointment scheduling and rescheduling, PCP changes, Devoted Medical onboarding visits and connection to appropriate care teams and resources
• Clinical Care Coordination: Applies established protocols and clinical tools to support members presenting with symptoms or critical lab results; processes medication refill requests, coordinates follow-up care, and ensures timely communication of health care updates to members
• Deliver Benefit and Program Education: Educate members on plan benefits, Devoted Medical programs, Enrollment opportunities, pharmacy benefits, Medicaid/LIS programs and other available resources
• Maintain Accurate Documentation: Ensure timely complete and accurate documentation to support continuity of care and reporting accuracy
• Collaborate Across Teams: Partner with CAs, Other CG's, Care Pathway Guides and clinical staff to close loops and resolve member needs efficiently
• Contribute to Team & Process Improvement: Participate in team meetings, learning opportunities, and workflow enhancements that improve member outcomes and operational effectiveness
• Adapt to Evolving Business Needs: Demonstrate flexibility in supporting changing priorities, communication channels, and operational workflows
• Our Member Services operation runs extended hours to ensure members can reach us when they need us
• Operational Hours by Season:

April - September: Monday - Friday (8:00 AM - 2:00 AM ET)

• Saturday (8:00 AM - 11:00 PM ET)

October - November: Sunday - Saturday (8:00 AM - 2:00 AM ET)

November

Benefits

• Comprehensive health plan
• 401K retirement plan
• Generous vacation and holiday time
• Lyra mental health resources
• Stock options

Schedule Flexibility: Must be dependable and able to work evenings, weekends, and holidays as business needs requireRemote Work Environment: Strong internet connection and a secure, private workspaceCritical Thinking & Problem Solving: Ability to evaluate situations, follow established protocols, and determine appropriate next steps to support member needsHealthcare Navigation & Care Coordination: Ability to support members through appointment scheduling, provider selection, benefit navigation, clinical order follow-up, and coordination of healthcare servicesActive Listening & Member Advocacy: Ability to identify member needs, connect information across systems, and proactively remove barriers to careAdaptability & Reliability: Thrives in a dynamic environment with evolving priorities and workflows while maintaining strong performance and accountabilityEmpathy & Emotional Intelligence: Demonstrates compassion, patience, and professionalism when supporting members through healthcare-related concernsAdvanced Problem Resolution: Proven ability to independently navigate complex member needs, apply established protocols, and coordinate resolution across multiple teams and stakeholders. (Prior experience in a Tier 2 support role a plus for internal candidates.)Digital Communication Proficiency: Strong written and verbal communication skills with the ability to effectively flex and help members across phone, chat, and digital platformsCollaboration & Teamwork: Works effectively with clinical teams, providers, and cross functional partners to coordinate member care and achieve positive outcomesProtocol Adherence: Comfort working within established protocols and escalation pathways while supporting members with time-sensitive healthcare needs