Member Support Specialist - Grievances

Salary Range: 65000 to 70000 (Currency: USD) (Pay period: per-year-salary)

About us:
Foodsmart is the leading Foodcare platform in the U.S., built to deliver nutrition-driven healthcare at scale. Powered by a national network of Registered Dietitians, Foodsmart combines personalized clinical nutrition care, behavior change tools, and food benefits to improve member health outcomes while lowering healthcare costs.

Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver sustainable health outcomes. Through our highly personalized, digital platform, we guide more than 3 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money.

Foodsmart seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing tangible access to nutritious food. In 2024, Foodsmart secured a $200 million investment from TPG’s Rise Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment helps us expand our reach, particularly to low-income workers who are disproportionately affected by diet-related diseases. 

At Foodsmart, our mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment:

👥 Customer First - You start with the member and work backwards.
🚀 Make It Happen - You act with urgency, use data, and hold high standards.
🤝 One Team - You collaborate with respect and commit as a group.

Whether you're a dietitian, a commercial leader, or a technologist, working at Foodsmart means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food.

About the role:

This role serves as the final point of contact for complex member issues, including grievances, advanced escalations, and accessibility or accommodation requests. This individual is responsible for resolving highly sensitive situations that require strong judgment, cross-functional coordination, and nuanced communication with members, health plans, and internal stakeholders.

The ideal candidate brings advanced critical thinking, emotional intelligence, and the ability to de-escalate challenging situations while ensuring members feel heard, supported, and respected.

You will:

Escalations & Grievance Management
• Own and resolve high-priority, complex, or sensitive member escalations end-to-end.
• Serve as the “last line” point of contact for unresolved member concerns.
• Investigate grievances thoroughly, synthesizing information from multiple systems and stakeholders.
• Ensure timely, compliant, and well-documented resolution of all escalations.
  
  
Accessibility & Accommodation Requests
• Review and assess accommodation and accessibility requests with sound judgment and consistency.
• Evaluate supporting documentation, including authorized representative forms and related records.
• Determine appropriate next steps, including approvals, denials, or escalations.
• Partner with internal teams to ensure accommodations are implemented and documented effectively.
 
Cross-Functional & External Communication
• Communicate professionally and clearly with health plans, providers, and external partners.
• Adapt communication style based on audience (members, executives, clinical and member support teams, partners).
• Translate complex issues into actionable insights for internal stakeholders.
 
De-escalation & Member Experience
• Lead de-escalation efforts with empathy, professionalism, and control.
• Balance compassion with boundary-setting to maintain productive interactions.
• Ensure members feel supported, respected, and confident in the resolution process.
 
Judgment & Decision-Making
• Make independent, high-stakes decisions within established guidelines.
• Identify when to escalate issues further vs. resolve directly.
• Recognize patterns and recommend improvements to reduce future escalations.

You are:

• Advanced Critical Thinker: Ability to assess complex, ambiguous situations and determine the best course of action.
• Agile in Communication: Strong written and verbal communication skills with the ability to tailor tone and messaging across audiences.
• Sound Judgment: Trusted to make decisions on sensitive accommodation and escalation cases.
• De-escalation & Mediation Minded: Proven ability to manage high-emotion interactions and drive resolution.
• Empathetic with Authority: Can create a supportive experience while maintaining control and direction of the conversation.
• Detail Oriented: Strong documentation and compliance mindset, especially with sensitive or regulated processes.
• Ethical and Accountable: Possesses strong sense of personal and professional ethics and will take accountability for actions and decisions. 

You have:

• Reliable high speed internet access with minimum speeds of roughly 100 Mbps download and 20 Mbps upload.
• A completely private, secure, and quiet workspace.
• Bachelor’s degree or higher.
• 3–5+ years in member/patient support, escalations, grievances, or case management.
• Experience working with health plans, healthcare systems, or regulated environments preferred.
• Demonstrated experience handling complex escalations or complaint resolution.
• Familiarity with accessibility and accommodation processes (preferred).
• Experience reviewing formal documentation (e.g., authorized representative forms, medical or legal documentation) is a plus.

Success in this role looks like:

• Complex escalations are resolved efficiently and thoughtfully.
• Members feel heard and supported—even in difficult situations.
• Health plan and partner communications are clear, professional, and effective.
• Accommodation decisions are consistent, fair, and well-documented.
• Trends in escalations are identified and fed back to improve the overall member experience.