You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

As a Member Advocate, you'll serve as a trusted guide and partner to members navigating serious diagnoses, high-cost medications, or complex healthcare decisions. You will ensure that they receive the right care, at the right time, with the right support, and never feel alone during their journey. Your role directly improves health outcomes and changes lives, offering a meaningful impact through fast-paced problem-solving.

Key Responsibilities

• Build strong relationships with members and act as their primary point of contact throughout their care journey.
• Provide clear, compassionate guidance and ensure members feel supported, informed, and confident.
• Proactively reach out to eligible members to discuss available programs, benefits, and next steps.
• Alert members of programs they may be eligible for based on their diagnosis, medication needs, and claims activity.
• Coordinate with internal teams to facilitate smooth enrollment and transition into appropriate programs.
• Maintain accurate documentation of outreach efforts and member decisions in internal systems.
• Guide members through advocacy programs and ensure connections to the right programs.
• Help members schedule appointments, navigate referrals, and verify benefits.
• Manage medication and specialty pharmacy needs, including tracking and coordinating prior authorizations.
• Support complex and high-risk cases, conducting scheduled check-ins and preparing case summaries for cross-functional care discussions.
• Coordinate pre-surgery and pre-procedure authorizations and align pre-op and post-op care needs.

Qualifications

• 2+ years in care management, specialty pharmacy, benefits navigation, or a related healthcare role.
• Strong understanding of insurance, benefit structures, referrals, and prior authorization workflows.
• Experience collaborating with providers, PBMs, or specialty pharmacies.

Skills

• Exceptional communication skills, both written and verbal, to break complex concepts into simple guidance.
• Empathy and patience to communicate with overwhelmed, scared, or frustrated individuals.
• Operational excellence and attention to detail.
• Ability to multitask and thrive in a fast-paced environment.
• Comfort and proficiency using technology such as CRM, Zendesk, and internal tools.

Additional Requirements

• Experience with internal member management & eligibility systems, Zendesk, CRM platforms, and specialty pharmacy platforms.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Our client company is an equal opportunity employer and values diversity. All employment is decided on the basis of qualifications, merit, and business need.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.