Member Care Advocate (MCA)
Included Health is on a mission to raise the standard of healthcare for everyone. We simplify healthcare by combining virtual and in-person care with expert navigation, comprehensive support, and technology that makes it easier for members to get the right care at the right time.
Our Member Care Advocates (MCAs) are some of the most visible representatives of this mission, helping members feel seen, supported, and confident in navigating their benefits and care options. MCAs are a trusted guide, helping members navigate the fundamentals of their healthcare benefits while delivering high-quality, empathetic support in a high-volume environment. This role requires strong critical thinking and ownership to navigate member needs effectively.
This is a remote position and requires a secure, distraction-free home office.
New MCA hires start their role in an 3-week paid training period with a strict schedule of 10 a.m. - 7 p.m. EST, Monday - Friday. Upon completion of the 3-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.
Provide Member-Centered Support in a High-Volume Environment: Answer inbound calls respectfully and empathetically, using clear, plain language to help members feel confident and informed.
Resolve Core Member Issues: Address a broad range of member needs, including:
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.