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Member Care Coordinator

Calibrate -
Remote

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Job Details

Full-time
$21 - $22 an hour
9 days ago

Benefits

Paid parental leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Parental leave
Employee assistance program
Vision insurance
Opportunities for advancement

Qualifications

Collaborate with healthcare professionals
Appeals
Overseeing health insurance pre-certification
Electronic health records (EHR) management
Phone communication
Triage
Efficiency improvement
Insurance claim appeals processing
Health insurance customer support
RMA
Patient advocacy
Care documentation
Mid-level
Patient service
Medical administrative support
Overseeing care coordination
Medical billing discrepancy resolution
Case appeal in utilization management
Records management
Zendesk
Medical denial trend identification
Issue tracking
Customer engagement
Health record tracking
Medical Assisting
Managing patient records
Care coordination
Managing patients as a clinical case manager
Escalation handling
Communication skills

Full Job Description

ABOUT US

Calibrate is on a mission to change the way the world treats weight by redefining obesity care as a matter of biology, not willpower. Designed by world leaders in metabolic health, our program combines clinical research, personalized coaching, and lifestyle intervention to deliver lasting weight loss and improved metabolic outcomes. With obesity as America’s largest chronic condition, impacting 175mm adults in a $600B market, we’re closing the care gap by offering the first value-based model in obesity treatment.

Since launching Direct-to-Consumer in 2020, we’ve expanded into Enterprise channels to improve access, and our app-based experience supports members with coaching, tailored education, daily tracking, and community engagement across the four pillars of metabolic health: food, sleep, exercise, and emotional wellbeing.

ABOUT THE ROLE

A Member Care Coordinator sits at the intersection of Member Experience and Clinical Operations. The role of a Member Care Coordinator is to ensure that members receive timely, coordinated, and high quality care; acting as the “glue” between the Clinical, Coaching, and Operational teams. They ensure smooth handoffs between teams, including but not limited to, tracking lab results, medication approvals, and any necessary clinical follow up to ensure members proceed through their journey seamlessly.

This is a full-time, hourly role with a hourly rate of $21-22 per hour. We are offering two different shifts:

8:00am - 4:30pm EST
9:30am - 6:00pm EST

KEY RESPONSIBILITIES

Execute critical clinical administrative workflows focusing on resolving readiness barriers to accelerate members toward provider review and medication access.
Facilitate provider workflow efficiency by preparing clinical documents and proactively triaging member needs for specialty support.
Facilitate structured handoffs of critical information to Clinical and Coaching teams to ensure timely follow-up regarding changes in medication, denials, or approved exception paths.
Engage in cross-functional meetings and work collaboratively with others departments to improve and maintain a high level of member care.
Identify and formally report recurring systemic issues, submission errors, or trends that contribute to operational friction.
Manage the end-to-end medication access workflow with complete ownership, including the proactive gathering of relevant clinical data, coordinating with clinicians for additional necessary information, complex Prior Authorization (PA) submission, denial investigation, appeal documentation, final determination and overrides when applicable.
Proactively contact members via phone and secure message to request necessary information (e.g., previous prescription history, documentation) and deliver clarity regarding complex PA status changes or delays.
Conduct outbound calls to insurance carriers, PBMs, and pharmacies to obtain specific case statuses, track documentation, and secure approvals.
Ensure all communication, investigation notes, and PA statuses are accurately logged in the case management system (e.g., Zendesk, MJD) to maintain a complete and auditable member record.
Initiate and resolve pharmacy-level rejections (e.g., refill too soon, insurance coding errors, wrong dose dispensed) by conducting outbound calls to dispensing pharmacies and PBM help desks.
Troubleshoot technical or administrative insurance issues that prevent successful claims processing.

QUALIFICATIONS

Completion of a formal medical assisting program is highly valued. Preference will be given to candidates who hold a national certification, such as Certified Medical Assistant (CMA) awarded by the AAMA or Registered Medical Assistant (RMA) awarded by the AMT.
Familiarity with case management systems (e.g., Zendesk), Electronic Health Records (EHR), and PA/e-prescribing platforms is highly desirable.
2+ years of high-volume customer service, call center, or patient advocacy experience, preferably in a healthcare, pharmacy, or PBM setting.
Demonstrated track record of managing complex, multi-step processes where follow-up and persistence are critical to success (i.e., comfortable making multiple calls to solve a single problem).
Exceptional verbal and written communication skills with the proven ability to handle challenging, escalated calls/messages with professionalism and empathy.

BENEFITS

At Calibrate, we’re committed to putting our team members in control of their health. In 2026, we are proudly offering the following benefits:

Enjoy a generous paid time off policy, including multiple paid company holidays, wellness days, and floating holidays to support your work-life blend.
Medical, dental, and vision benefit options to keep you and your family healthy.
Calibrate-funded disability and basic life insurance, ensuring peace of mind during unforeseen events.
Access to several wellness programs, including a complimentary Headspace membership, and therapy on your schedule with Headspace Care.
Employee Assistance Program through Principal to receive counseling on a wide range of topics.
Remote-first ways of working, with the flexibility to work from any state.
Competitive paid parental leave program to support new parents.

OUR VALUES

Members First. Always.

Every decision starts with one question - Will this improve the health and the experience of the people we serve?

Outcomes That Matter.

We measure success through sustained weight loss and meaningful improvements in cardiometabolic health.

Integrated Care Wins.

Obesity care requires more than medication alone. We combine clinical care, behavior change, and technology into one coordinated care model.

Relentless Improvement.

We continuously learn from outcomes, data, and our experience to refine our care model and raise the standard of obesity treatment.

Great Partners.

We strive to be easy to work with and trusted by patients, employers, clinicians, partners, and our fellow Calibraters.

Calibrate is proud to be an equal opportunity workplace, providing equal employment and advancement opportunities to all team members. To achieve our mission of changing the way the world treats weight, we are building an environment where every Calibrater can thrive, feel a sense of belonging, and do the best work of their careers. We value diversity and recruit, hire, and promote individuals solely based on talent, qualifications, competence, and merit. We evaluate candidates without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics as required by law and as a matter of our company values.

#LI-REMOTE

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Refine Your Search

shift coordinator jobs

Member Care Coordinator

Support Operations Coordinator - US Remote

Case Coordinator I

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Home Care - CNA

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