Member Care Advocate (MCA) - Bilingual at Included Health

At Included Health, our mission is to raise the standard of healthcare for everyone. As a Member Care Advocate (MCA), you will embody this mission and act as a trusted guide to our members. You will help members navigate the complexities of their healthcare benefits and play a critical role in simplifying their healthcare journey. MCAs do this by handling a high-volume of interactions with members, helping them on their healthcare journey from start to finish. This role reports directly to the Member Advocacy team leadership and is an individual contributor position.   This is a remote position and requires a secure, distraction-free home office.   New MCA hires start their role in an 8-week paid training period with a strict schedule of 10 a.m. - 7 p.m. EST, Monday - Friday. Upon completion of the 8-week training period, employees will transition to their regular schedule as outlined during their offer and onboarding process. Missing work, leaving early, or arriving late without proper notice is considered an unplanned absence.  Please note: No planned time off is permitted during the training period. Responsibilities • You will answer a high volume of inbound calls from English and Spanish-speaking members, providers, and vendors, ensuring every interaction is respectful, compassionate, and solution-oriented. • You will be a part of a team that manages all member inquiries, utilizing all available resources to provide precise, accurate information and aiming for first-call resolution - minimizing member effort. • You will own the member's journey, including researching and resolving complex cases, answering health plan-related questions, billing and claims inquiries, prior authorizations, and benefits coverage questions. • You will guide members in accessing the services that best meet their needs. This includes facilitating access to virtual care services, obtaining second opinions from experts, and connecting members to other valuable healthcare resources. For clinical opportunities, you will be tasked with internal routing and ensuring the member's continuity of care. • You will clearly explain all available benefits and help members understand their healthcare options in their preferred language, ensuring they are well-informed to make the best decisions for their health. • You will expertly utilize VoIP phone systems (e.g., CXOne), Google apps, Apple products, and customer relationship management (CRM) software, to navigate and document member interactions. • You will articulate Included Health's mission and understand the scope of our services to deliver consistent, high-quality advocacy to members. • You will ensure every interaction is high-quality and provide service that is perceptive, skilled, and focuses on our members. Qualifications • Bilingual proficiency; full fluency in both English and Spanish is required. • Bachelor's degree with 2 years of healthcare experience, OR 5 years of relevant experience in healthcare field. • Experience using VoIP phone systems (e.g., CXOne) AND comfortable handling a high volume of calls the entire day. • Robust knowledge with Google apps, Apple products, and customer relationship management software, with proven ability adapting to proprietary tools. • Must be able to complete the 8-week paid training period with no planned time off permitted. Training is 10 a.m. - 7 p.m. EST Monday - Friday. Pay: The United States new hire hourly rate for this contract position is: $22.00   Benefits: Medical and Dental, will be provided and managed by Contracting Agency.   You can become eligible to transition to a permanent position after 5 months of contract work.   Our compensation & benefits include:   Excellent medical, dental, and vision insurance, plus extensive benefits through our own product (IH4IH) from day one including free virtual primary care, urgent care, and behavioral health.   Support via our Employee Assistance Program and the Golden Ticket program for family and friends.   We offer competitive salaries with a new hire rate of $25.10 per hour, reflecting expanded responsibilities and our commitment to a living wage.   A work-from-home (WFH) stipend to cover your internet expenses and a 401(k) plan with a 50% match on your contributions, up to 6%.   Paid time off, generous parental leave, company-wide holidays, and paid volunteer time.   As a rapidly expanding company, we offer numerous opportunities for career advancement and professional development. About Included Health Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com. ----- Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law.