Member Service Representative (Remote - United States)
About The Position
Upside is hiring a Member Service Representative to support high-need members navigating housing instability. In this role, you’ll serve as a member’s primary point of contact and a steady guide through next steps. This role is equal parts member support and operational execution. You will manage a caseload of members, run structured check-ins, identify barriers, and connect patients to the right resources. This is a fast-paced, metrics-driven role for someone who brings high empathy and high urgency. You know how to build trust, prioritize member needs, and operate efficiently so you can provide consistent support across your full caseload. You’ll use Salesforce daily to track outreach, prioritize follow-ups, and ensure a strong member experience that drives satisfaction and retention. This role reports to the SVP, Clinical Operations. Internally, this position is referred to as a Care Guide.
Requirements
- 1–3+ years of experience in member services, care navigation, eligibility/referrals, community-based services, healthcare call center, or a similarly fast-paced member-facing role
- Experience supporting Medicaid members and/or unhoused or housing-insecure populations
- Comfort working in a structured, metrics-driven environment with clear activity expectations and follow-up SLAs
- Strong phone presence with the ability to build rapport quickly, communicate clearly, and keep conversations focused on next steps
- High ownership and organization, including experience managing a book of work or caseload and staying on top of follow-ups
- Strong attention to detail and ability to document accurately in tools like Salesforce (or similar CRM/workflow systems)
- Ability to navigate complex member situations with empathy while maintaining boundaries and moving work forward
Nice To Haves
- Experience supporting housing navigation or related programs, and/or relevant certifications or licenses (HUD certification, CHW certification, MSW, LCSW) preferred but not required
- Familiarity with housing instability and social determinants of health is a plus
- Spanish fluency is a plus
Responsibilities
- Own a caseload of members and serve as their primary point of contact throughout their housing support journey
- Conduct structured weekly (or as-needed) check-ins to assess progress, remove blockers, and maintain engagement
- Create clear, practical next steps with members and keep momentum through consistent follow-up and accountability
- Coordinate housing-related actions, including gathering information, supporting applications, and working with partners to move placements forward
- Refer members to other community resources when needed (food resources, local CBOs, and other supports)
- Use Salesforce daily to track outreach, update member status, document interactions, and manage tasks and follow-ups
- Prioritize your day using workflow queues, urgency, and member risk to ensure timely outreach and resolution
- Identify barriers early (documentation issues, communication gaps, readiness, access challenges) and escalate appropriately to unblock progress
- Partner closely with internal teams and external partners to coordinate handoffs, align on next steps, and ensure members receive consistent information
- Maintain high-quality documentation and outcomes tracking to support reporting and continuous improvement
- Contribute feedback on workflows, templates, and resources to improve speed, clarity, and member experience over time
Benefits
- Medical, dental, and vision coverage
- Paid time off and company holidays
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
