Member Support Specialist, Escalations & Grievances

Justremote; United States; Remote; USD 40,000 - 46,000; Full time

Benefits offered by this job

Unlimited PTO

Healthcare Coverage (Medical, Dental, 

Job summary

Foodsmart is a remote-first company seeking a dedicated specialist to own and resolve high-priority member escalations end-to-end. You will collaborate with Clinical Operations on escalations and grievances, investigate safety concerns, and communicate clearly with health plans and providers.

The role emphasizes translating complex issues into actionable insights for internal teams, maintaining documentation, and guiding de-escalation efforts with empathy and control.

Qualifications

• 1–3+ years in member/patient support, escalations, grievances, or case management.
• Experience with health plans, healthcare systems, or regulated environments preferred.
• Strong ability to handle complex escalations and complaints.

Responsibilities

• Own and resolve high-priority, complex member escalations end-to-end.
• Own all escalations and grievances relating to RDs end-to-end with Clinical Operations.
• Investigate member behavior and safety concerns and act as the last line of contact.
• Translate complex issues into actionable insights for internal teams.
• Lead de-escalation efforts with empathy and professionalism.

Job description

About:

• Own and resolve high-priority, complex, or sensitive member escalations end-to-end.
• Own all escalations and grievances relating to RDs end-to-end and collaborate with the Clinical Operations team.
• Investigate RD reports of member behavior and safety concerns.
• Serve as the 'last line' point of contact for unresolved member concerns.
• Investigate escalated or complex member and internal requests relating to member profile and food benefit issues.
• Ensure timely, compliant, and well-documented resolution of all escalations.
• Communicate professionally and clearly with health plans, providers, and external partners.
• Adapt communication style based on audience.
• Translate complex issues into actionable insights for internal stakeholders.
• Manage and escalation benefit and account issues to engineering and product teams.
• Lead de-escalation efforts with empathy, professionalism, and control.
• Maintain communication standards and ensure accuracy of resources.
• Make independent, high-stakes decisions within established guidelines.

Experience:

• Reliable high speed internet access with minimum speeds of roughly 100 Mbps download and 20 Mbps upload.
• A completely private, secure, and quiet workspace.
• 1–3+ years in member/patient support, escalations, grievances, or case management.
• Experience working with health plans, healthcare systems, or regulated environments preferred.
• Demonstrated experience handling complex escalations or complaint resolution.
• Experience working in technically complex roles.

Salary and Perks:

Pay range: $40K - $46K

• Remote-First Company
• Unlimited PTO
• Flexible & remote location
• Healthcare Coverage (Medical, Dental, Vision)
• 401k & bonus
• Registered Dietitian Sessions

About Foodsmart:

A digital personal nutrition expert.