Remote NC Medicaid Member Services Specialist

Vaya Health; Raleigh (NC); Remote; USD 52,000 - 76,000; Full time

Job summary

Vaya Health in North Carolina is seeking an ACCESS Member Services Specialist to help individuals access needed services. This home-based role requires residency within NC or within 40 miles of the NC border and a 40-hour week.

You will conduct screening calls, link callers to providers, collect demographic information, and connect to clinicians for urgent needs, while following HIPAA and NC regulations in a supportive, recovery-focused manner.

Qualifications

• Bachelor’s degree in a Human Services field with relevant experience.
• Qualified Professional per 10A NCAC 27G .0104.
• Strong knowledge of social work and recovery principles.

Responsibilities

• Handle telephonic service requests and link callers to providers.
• Assess needs, verify eligibility, and schedule appointments within time standards.
• Provide information on Medicaid services in NC and community resources.

Skills

Behavioral health knowledge

De-escalation

Communication skills

Recovery-oriented approach

Cross-functional collaboration

Education

Bachelor’s degree in Human Services

Job description

Vaya Health in North Carolina is seeking an ACCESS Member Services Specialist to help individuals access needed services. This home-based role requires residency within NC or within 40 miles of the NC border and a 40-hour week.

You will conduct screening calls, link callers to providers, collect demographic information, and connect to clinicians for urgent needs, while following HIPAA and NC regulations in a supportive, recovery-focused manner.