Member Care Coordinator

ABOUT US

Calibrate is on a mission to change the way the world treats weight by redefining obesity care as a matter of biology, not willpower. Designed by world leaders in metabolic health, our program combines clinical research, personalized coaching, and lifestyle intervention to deliver lasting weight loss and improved metabolic outcomes. With obesity as America’s largest chronic condition, impacting 175mm adults in a $600B market, we’re closing the care gap by offering the first value-based model in obesity treatment.

Since launching Direct-to-Consumer in 2020, we’ve expanded into Enterprise channels to improve access, and our app-based experience supports members with coaching, tailored education, daily tracking, and community engagement across the four pillars of metabolic health: food, sleep, exercise, and emotional wellbeing.

ABOUT THE ROLE

A Member Care Coordinator sits at the intersection of Member Experience and Clinical Operations. The role of a Member Care Coordinator is to ensure that members receive timely, coordinated, and high quality care; acting as the “glue” between the Clinical, Coaching, and Operational teams. They ensure smooth handoffs between teams, including but not limited to, tracking lab results, medication approvals, and any necessary follow up to ensure members proceed through their journey seamlessly.

This is a full-time, hourly role with a hourly rate of $20-22 per hour. We are offering three different shifts:

- Monday - Friday 8am - 4:30pm ET

- Monday - Friday 9:30am - 6pm ET

- Monday - Friday 10:30am - 7pm ET

KEY RESPONSIBILITIES

- Execute critical clinical administrative workflows focusing on resolving readiness barriers to accelerate members toward provider review and medication access.

- Own member escalations, including issue resolution and member communication.

- Facilitate provider workflow efficiency by preparing clinical documents and proactively triaging member needs for specialty support.

- Facilitate structured handoffs of critical information to Clinical and Coaching teams to ensure timely follow-up regarding changes in medication, denials, or approved exception paths.

- Engage in cross-functional meetings and work collaboratively with other departments to improve and maintain a high level of member care.

- Identify and formally report recurring systemic issues, submission errors, or trends that contribute to operational friction.

- Manage the end-to-end medication access workflow with complete ownership, including the proactive gathering of relevant clinical data, coordinating with clinicians for additional necessary information, complex Prior Authorization (PA) submission, denial investigation, appeal documentation, final determination and overrides when applicable.

- Proactively contact members via phone and secure message to request necessary information (e.g., previous prescription history, documentation) and deliver clarity regarding complex PA status changes or delays.

- Conduct outbound calls to insurance carriers, PBMs, and pharmacies to obtain specific case statuses, track documentation, and secure approvals.

- Ensure all communication, investigation notes, and PA statuses are accurately logged in the case management system (e.g., Zendesk, MJD) to maintain a complete and auditable member record.

- Initiate and resolve pharmacy-level rejections (e.g., refill too soon, insurance coding errors, wrong dose dispensed) by conducting outbound calls to dispensing pharmacies and PBM help desks.

- Troubleshoot technical or administrative insurance issues that prevent successful claims processing.

BACKGROUND & EXPERIENCE

- Completion of a formal medical assisting program is highly valued. Preference will be given to candidates who hold a national certification, such as Certified Medical Assistant (CMA) awarded by the AAMA or Registered Medical Assistant (RMA) awarded by the AMT.

- Familiarity with case management systems (e.g., Zendesk), Electroni