Member Service Guide: Care Guide

**Job Description** ***A bit about this role:*** 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. ***Responsibilities and Impact will include:*** * **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. ***Required skills and experience:*** * **Advanced 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.)* * **Healthcare Navigation \& Care Coordination:** Ability to support members through appointment scheduling, provider selection, benefit navigation, clinical order follow\-up, and coordination of healthcare services. * **Protocol Adherence:** Comfort working within established protocols and escalation pathways while supporting members with time\-sensitive healthcare need