Member Care Coordinator, Clinical

OUR MISSION

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 DTC 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.

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 clinical follow up to ensure members proceed through their journey seamlessly.

KEY RESPONSIBILITIES

• Execute critical clinical administrative workflows focusing on resolving readiness barriers to accelerate members toward provider review and medication access.
• 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 others 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 AND 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), Electronic Health Records (EHR), and PA/e-prescribing platforms is highly desirable.
• 2+ years of high-volume customer service, call center, or patient advocacy experience, preferably in a healthcare, pharmacy, or PBM setting.
• Demonstrated track record of managing complex, multi-step processes where follow-up and persistence are critical to success (i.e., comfortable making multiple calls to solve a single problem).
• Exceptional verbal and written communication skills with the proven ability to handle challenging, escalated calls/messages with professionalism and empathy.

SKILLS AND ATTRIBUTES

• Demonstrated proficiency in medical terminology and clinical documentation to accurately interpret patient charts, understand treatment plans, and effectively communicate with clinical providers and payers.
• Strong organizational skills and meticulous attention to detail in documentation.
• Proficiency in interpreting and translating complex insurance terminology for the member.
• Proactive problem solver with a self-starter mentality.
• Ability to work independently and manage case load effectively.

Salary: $21-22/hr

BENEFITS

At Calibrate, we’re committed to putting our team members in control of their health. In 2025, we are proudly offering the following benefits:

• Attractive salaries with opportunities for equity in our early-stage, high-growth company.
• Enjoy a generous paid time off policy, including multiple paid company holidays, wellness days, and floating holidays to support your work-life blend.
• Medical, dental, and vision benefit options to keep you and your family healthy.
• Calibrate-funded disability and basic life insurance, ensuring peace of mind during unforeseen events.
• Access to several wellness programs, including a complimentary Peloton membership, Headspace membership, and therapy on your schedule with Headspace Care.
• Employee Assistance Program through Prudential to receive counseling on a wide range of topics.
• Remote-first ways of working, with the flexibility to work from any state.
• Competitive paid parental leave program to support new parents.

OUR VALUES

We’re in it together: We have an audacious mission, and we’re building a lot of things for the first time — from the first DTC pharma business within the healthcare ecosystem to the data infrastructure for providing real-world evidence in the largest category of chronic disease. It takes superpowers to build something simple and intuitive within the complex healthcare market, so we identify and work as a team from our individual points of strength. Not everyone has to be good at everything, but we know that when we harness what we’re each great at, we’re unstoppable.

Small wins create big wins: We ground every experience in optimism, recognizing and celebrating successes along the way. We break projects down into smaller components. And we focus on where we have momentum. We always plan for larger goals with the knowledge that our plans will evolve as we achieve smaller milestones.

You’re in control: We don’t let location stand in the way of the best talent — and from coaches to engineers, we are a remote-first team. Our business is multi-faceted, so each Calibrater is hired to be an expert in their piece of it — in control of their own initiatives, in control of their own impact, and in control of driving their own (real) results.

Real results matter: We’re obsessed with outcomes because when our members win, we win, and the data proves that we’ve built the best metabolic health program on the market. We’re purposeful, optimistic, and relentlessly confident that we can solve the biggest medical issue of the 21st century.

Calibrate is proud to be an equal opportunity workplace, providing equal employment and advancement opportunities to all team members. To achieve our mission of changing the way the world treats weight, we are building an environment where every Calibrater can thrive, feel a sense of belonging, and do the best work of their careers. We value diversity and recruit, hire, and promote individuals solely based on talent, qualifications, competence, and merit. We evaluate candidates without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics as required by law and as a matter of our company values.  

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