Member Service Guide: Care Guide (Bilingual, Spanish)

About This Opportunity

We are representing a confidential Medicare Advantage organization in their search for a bilingual Member Service Guide to serve as a compassionate front door for Spanish and English-speaking members navigating their healthcare journey. In this remote role, you'll guide members through appointments, benefits, care coordination, and clinical support needs across phone, chat, and digital channels—transforming complex healthcare navigation into clear, empowering experiences.

Responsibilities

• Deliver exceptional bilingual support to English and Spanish-speaking members with empathy, accuracy, and first-contact resolution focus
• Coordinate care navigation including provider searches, appointment scheduling, PCP changes, and connection to appropriate care teams
• Apply clinical protocols to support members with symptoms or critical lab results; process medication refill requests and coordinate follow-up care
• Educate members on plan benefits, pharmacy programs, Medicaid/LIS, and enrollment opportunities
• Maintain accurate, timely documentation to support continuity of care and reporting
• Collaborate with care teams and clinical staff to resolve member needs efficiently
• Participate in team meetings and process improvements to enhance member outcomes
• Adapt to evolving priorities, communication channels, and operational workflows

What We're Looking For

• Professional fluency in both English and Spanish (written and oral) – required
• Advanced problem resolution skills with ability to navigate complex member needs independently
• Healthcare navigation and care coordination experience, including appointment scheduling, benefit navigation, and clinical order follow-up
• Strong written and verbal communication skills across phone, chat, and digital platforms in both languages
• Active listening and member advocacy abilities; skill at identifying needs and removing barriers to care
• Critical thinking and protocol adherence when supporting time-sensitive healthcare situations
• Empathy, patience, and emotional intelligence when supporting members through healthcare concerns
• Collaboration skills to work effectively with clinical teams and cross-functional partners
• Adaptability and reliability in a dynamic environment with changing priorities
• Schedule flexibility required: must be available for evenings, weekends, and holidays as needed; operational hours vary by season (extended coverage Sunday–Saturday, 8 AM–2 AM ET during peak periods)
• Strong internet connection and secure, private home workspace for remote work
• Prior Tier 2 support experience is a plus

How We Work with You

When you apply through Get A Job.ai, our talent team will screen your qualifications and experience. If there's a strong match, we'll submit your profile to our client for consideration. You'll work directly with our recruiters throughout the interview process. Please do not contact the client organization directly—all communication and coordination flows through Get A Job.ai to ensure the best experience for everyone involved.

Pay

Pay via Get A Job.ai has not been specified for this position. Compensation details will be discussed during the screening process.

Employment Type: Full-time, remote (United States)

Get A Job.ai is an equal opportunity employer. We are committed to building a diverse team and creating an inclusive environment where all qualified applicants receive consideration without regard to race, color, religion, sex, national origin, disability, age, veteran status, sexual orientation, gender identity, or any other protected characteristic.