Job Description

Bilingual Member Services Representative (Remote, Spanish Speaking)

At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve.

We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.

Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.

We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions .

At Pair Team, we're not just delivering care - we're building the future of more equitable, community-driven healthcare.

Our Values

• Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.
• Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.
• Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.
• Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.
• Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.

About the Opportunity

Pair Team is building a team of deeply passionate individuals ready to change primary care operations for those who need it most. We are looking for a highly motivated full-time Lead Care Manager who is willing to think creatively and empathically to help our team change the way people access healthcare.

We seek a full-time Bilingual Member Services Representative to play a critical role in our whole-person, interdisciplinary care model, responsible for directly outreaching and engaging with individuals living with Serious Mental Illness/ Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. We believe in the power of trust and relationships to successfully engage those who may have never received the kind of whole-health care that Pair Team can provide. The Bilingual Member Service Representative will hold the title of a Lead Case Manager.

This position primarily allows for remote work; however, it includes 2-3 times a month on-site visits in the community alongside a fellow PairMate. You can expect to engage in these in-person activities 2-3 times per month, close to your city, while the majority of your duties, approximately 90%, will be performed from your home.

What You'll Do

• Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health goals
• Use relationship-based strategies to support members with social support navigation, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system
• Conducts periodic telephonic and SMS outreach to ensure timely follow-up to members
• Work with member to identify health/wellness goals and incorporate goals into Health Action Plan/Shared Care Plan
• Supports nurse care manager, behavioral health care manager, nurse practitioner and Community Engagement Specialist with delegated tasks
• Collaborates on care issues with Enhanced Care Management team by participating in systematic case reviews and consulting with nurse care manager, behavioral health care manager, and nurse practitioner before taking clinical actions
• Consistently meet monthly encounter metrics to ensure compliance with health plan regulations
• Identify and break down barriers ensuring individuals' continuation with the program
• Assists individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups
• Coordinate physical care management appointments through collaboration with external and internal providers
• Utilize external and internal online platforms to collaborate with team members and carry out daily tasks

What You'll Need

• 3+ years of general work experience (healthcare call environments preferred)
• You are physically located in California
• Bilingual English/Spanish
• Telehealth experience in high volume call settings (inbound and outbound)
• Strong understanding of cultural fluency
• High degree of empathy
• Ability to work collaboratively in a multidisciplinary team
• An eye for optimization
• Organizational skills
• Ability to remain patient when faced with adversity
• Strong technical skills and comfort with technology innovation, past experience with CRM databases, basic Excel, Word, email, and video conferencing
• A valid driver's license and auto liability insurance

Preferred Qualifications:

• Demonstrated professional or personal lived experience working closely with individuals experiencing complex chronic needs, homelessness, or Severe Mental Illness/Substance Use Disorder
• 2+ years of case management experience
• Experience with motivational interviewing
• Knowledge of medical terminology
• Zest for problem solving, seeking answers, and thinking outside the box
• Detail-oriented and organized self-starter who is a rockstar multitasker
• Reliable and comfortable in an ever-changing environment

Because We Value You

• Salary: $22-$25/hour
• Comprehensive health, vision & dental insurance
• 401k
• Monthly $100 work from home expense stipend for your WFH days
• Gas reimbursements for your on-site engagement days
• Flexible vacation policy -- take the time you need to recharge!
• We provide all of the equipment needed for the role
• Opportunity for rapid career progression with plenty of room for personal growth!

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