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Member Care Advocate (MCA) - November Cohort

Included Health· Ops/Member Care – Member Care
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RemoteContractPosted 4w ago

About the role

Remote, contract Member Care Advocate role with 3-week paid training. Responsible for empathetic, high-volume member support navigating benefits and care options, with knowledge of benefits, costs, and provider navigation.

Responsibilities

  • Provide Member-Centered Support in a High-Volume Environment: Answer inbound calls and chats respectfully and empathetically, using clear, plain language to help members feel confident and informed.
  • Resolve Core Member Issues: Explaining benefits coverage, cost-sharing concepts (deductibles, copays, coinsurance, and out-of-pocket maximums), and basic eligibility details.
  • Finding and confirming in-network providers, updating account information, and providing simple status updates on existing requests.
  • Connecting members to available programs (such as virtual care) by guiding them through standard enrollment or scheduling steps.
  • Own Issues and Empower Members: Resolve clearly defined questions end-to-end using established workflows and scripting, while educating members to reduce future confusion and repeat contacts.
  • Leverage Tools and Resources: Navigate Included Health systems, knowledge bases, and carrier portals to research questions and identify the right next step.
  • Accurately document interactions and follow-up actions, ensuring clear, concise notes that enable continuity of care across the team.
  • Deliver Consistent Quality: Meet or exceed expectations for quality audits and member satisfaction (MSAT), while clearly articulating Included Health's mission and commitment to reducing friction in healthcare.

Qualifications

  • Bachelor's degree with a minimum of 2 years of customer service or healthcare experience, OR 5 years of relevant experience in healthcare or benefits navigation.
  • Comfortable handling a high volume of inbound calls throughout the day using VoIP phone systems (e.g., CXOne).
  • Strong familiarity with Google Workspace, Apple products, and CRM software, with the ability to learn proprietary tools quickly.
  • Exceptional customer service skills, with the ability to act as a member advocate, de-escalate challenging situations, and maintain a professional, friendly demeanor.
  • Strong verbal communication skills for phone interactions, including the ability to explain benefits, processes, and next steps clearly and confidently.
  • Strong written communication skills in English for accurate, clear documentation of member interactions.
  • Demonstrated ability to think critically within defined workflows, identify when something doesn't look right, and use available resources to resolve well-scoped issues.
  • Comfortable gathering information, asking clarifying questions, and structuring a clear summary when additional follow-up by other teams is needed.
  • Understands and follows HIPAA guidelines and maintains member confidentiality at all times.
  • Ability to work from a secure, distraction-free home office with reliable internet, and the discipline to succeed in a remote environment.
  • Must be able to complete the 3-week paid training period with no planned time off permitted. Training is 10 a.m. - 7 p.m. EST Monday - Friday.

Skills

Required:Customer serviceCommunication (verbal)Communication (written)HIPAA knowledge
Last updated Oct 21, 2026. Interested? Apply on the company site.

About Included Health

Designed to treat you better.™

Included Health delivers personalized virtual care, navigation, and cost-saving healthcare solutions for employers, health plans, and members.

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