Twin Health
Twin Health invented the Whole Body Digital Twin™ to help reverse and prevent chronic metabolic diseases.
Member Services Specialist - Benefits Navigation
Location
United States
Posted
3 days ago
Salary
Not specified
No structured requirement data.
Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
The Stewardship Program Lead serves as the bridge between complex clinical policy and our potential member base. You will own the resolution of high-priority escalations regarding medication coverage, GLP-1 stewardship, and clinical eligibility.
- Own the Outcome: Serve as the primary point of contact for complex member escalations, untangling issues related to prior authorizations, benefit changes, and eligibility requirements.
- Navigate the Complex: Interpret intricate clinical protocols and insurance benefits, translating "insurance speak" into clear, actionable, and empathetic guidance for members.
- Master the "Difficult" Conversation: Engage with frustrated or skeptical members who may be mandated to join the program, turning high-tension moments into opportunities for education and partnership.
- Operational Excellence: Partner with Clinical Operations and external partners to identify "friction points" in the member journey, helping to build processes to prevent future issues.
- Advocate & Educate: Shift the member’s perspective from "compliance" to "impact," helping members see the value of the Twin program.
- Specialize in member retention efforts, partnering with cross-functional teams to identify engagement barriers and implement targeted strategies.
- Other duties as assigned.
Qualifications
- Passion for improving the health and lives of our members.
- 3-5 years of experience in Care Coordination, Patient Advocacy, Pharmacy Benefit Management (PBM), or Clinical Operations.
- Proven track record of managing high-volume, high-complexity member escalations.
- Deep familiarity with Prior Authorization (PA) processes and clinical eligibility criteria (experience with GLP-1s is a major plus).
- Exceptional verbal and written communication skills - you can simplify the complex on the fly.
- Highly adaptable and nimble, able to switch seamlessly between answering calls and working on independent projects with minimal supervision.
- Proven track record of remaining calm, flexible, and solution-oriented in high-stress situations and de-escalating complex member interactions.
- Moderate to advanced technical proficiency across multiple platforms (Salesforce and Zendesk experience preferred).
- Strong organizational skills with the ability to manage competing priorities and maintain accuracy.
- High school diploma or equivalent required; Associate's degree preferred.
- Availability to work 9am-5pm PST.
- Startup experience is a plus.
Requirements
- This remote opportunity is available to US-based candidates.
- Applicants must be authorized to work for any employer in the U.S.
- We are unable to sponsor or take over sponsorship of an employment Visa at this time.
Compensation and Benefits
- The compensation for this position is $70,000 annually.
- A competitive compensation package in line with leading technology companies.
- A remote and accomplished global team.
- Opportunity for equity participation.
- Unlimited vacation with manager approval.
- 16 weeks of 100% paid parental leave for delivering parents; 8 weeks of 100% paid parental leave for non-delivering parents.
- 100% Employer sponsored healthcare, dental, and vision for you, and 80% coverage for your family; Health Savings Account and Flexible Spending Account options.
- 401k retirement savings plan.
Job Requirements
- Passion for improving the health and lives of our members.
- 3-5 years of experience in Care Coordination, Patient Advocacy, Pharmacy Benefit Management (PBM), or Clinical Operations.
- Proven track record of managing high-volume, high-complexity member escalations.
- Deep familiarity with Prior Authorization (PA) processes and clinical eligibility criteria (experience with GLP-1s is a major plus).
- Exceptional verbal and written communication skills - you can simplify the complex on the fly.
- Highly adaptable and nimble, able to switch seamlessly between answering calls and working on independent projects with minimal supervision.
- Proven track record of remaining calm, flexible, and solution-oriented in high-stress situations and de-escalating complex member interactions.
- Moderate to advanced technical proficiency across multiple platforms (Salesforce and Zendesk experience preferred).
- Strong organizational skills with the ability to manage competing priorities and maintain accuracy.
- High school diploma or equivalent required; Associate's degree preferred.
- Availability to work 9am-5pm PST.
- Startup experience is a plus.
- This remote opportunity is available to US-based candidates.
- Applicants must be authorized to work for any employer in the U.S.
- We are unable to sponsor or take over sponsorship of an employment Visa at this time.
- Compensation and Benefits
- The compensation for this position is $70,000 annually.
- A competitive compensation package in line with leading technology companies.
- A remote and accomplished global team.
- Opportunity for equity participation.
- Unlimited vacation with manager approval.
- 16 weeks of 100% paid parental leave for delivering parents; 8 weeks of 100% paid parental leave for non-delivering parents.
- 100% Employer sponsored healthcare, dental, and vision for you, and 80% coverage for your family; Health Savings Account and Flexible Spending Account options.
- 401k retirement savings plan.