SCN Member Services Specialist

Ready to Make a Difference? If you're passionate about helping individuals overcome barriers to care and connecting them with the resources they need to thrive, we encourage you to apply today. Join FLIPA and become part of a mission-driven team dedicated to improving health outcomes and strengthening communities across Upstate New York.

Title: SCN Member Services Specialist Reports To: TBD Location: Hybrid (Periodic in-person meetings required) About Forward Leading IPA (FLIPA) Forward Leading IPA (FLIPA) is a nonprofit membership association of safety net providers dedicated to improving healthcare outcomes for underserved populations across Upstate New York.

Through integrated primary care, behavioral health, and social care services, FLIPA works collaboratively with healthcare providers and community organizations to address the whole-person needs of the communities we serve.

Position Summary

The Member Service Specialist is a dedicated position within the Internal Hub responsible for member status visibility, complaint prevention, coordination issue resolution, and compliance support. This role serves as SCN's primary contact for members seeking updates regarding referrals, services, authorizations, and care coordination activities.

The Member Service Specialist bridges communication gaps between members, care managers, providers, community organizations, and the Internal Hub to ensure members receive accurate information and timely assistance. This position plays a critical role in reducing complaints, improving member satisfaction, and supporting SCN's accountability and reporting obligations as a lead entity.

Key Responsibilities

Respond to member inquiries regarding referrals, services, authorizations, and care coordination. Track referral status and provide timely updates to members and stakeholders. Investigate and resolve member concerns in collaboration with care managers, providers, and community partners. Document member interactions, complaints, resolutions, and follow-up activities.

Monitor referral outcomes and identify barriers to service completion. Support compliance reporting, quality initiatives, and audit preparation. Maintain accurate records and contribute to process improvement efforts.

Qualifications

Bachelor's degree in social work, Human Services, Public Health, Healthcare Administration, Nursing, Psychology, or a related field. OR Minimum 3 years of experience in member services, healthcare, care coordination, customer service, or a related area. Strong communication, problem-solving, and customer service skills.

Ability to manage sensitive situations with professionalism, empathy, and confidentiality.

Preferred Qualifications

Experience with Medicaid, managed care, healthcare navigation, or social care programs. Familiarity with referral management systems, electronic records, and complaint tracking. Knowledge of community resources and care coordination workflows. Bilingual or multilingual skills are preferred .

Compensation

$23.00 – $24.00 per hour , commensurate with education and experience.

Benefits

401(k) with Company Match Medical Insurance Dental Insurance Vision Insurance Health Savings Account (HSA) Flexible Spending Account (FSA) Paid Time Off (PTO) Mileage Reimbursement