Member Experience Associate (Temporary)

Location: Remote - CA, California US

Notice

This position is no longer open.

Job Number: 3561

Position Title: Member Experience Associate

External Description:

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

Summary
The Member Experience Associate assists plan members with their concerns or complaints and provides the necessary information and education to resolve concerns. Focusing on delighting members by exceeding their expectations and paying attention to detail by acting as a single point of contact to deliver needed care for the best member experience by acting as the liaison between the member and all other member facing departments to obtain first call resolution.


Essential Duties and Responsibilities
Essential duties and responsibilities include, but are not limited to:
1. Seeks and understands the needs and expectation of internal and external customers in a friendly, positive and outgoing manner.
2. Explains the plan’s procedures, protocols, benefits, services, and any other necessary information to the members who telephone or visit the Member Services Department.
3. Goes above and beyond to address all of the member’s inquiries and needs, focusing on first call resolution.
4. Ensures timely and adequate follow up to ensure member is satisfied with the outcome and resolution of open or pending items until completely resolved.
5. Facilitate member requests for changes with network provider changes, transportation requests, appointment scheduling, or any other member request for assistance as appropriate.
6. Answer all incoming member phone calls within the department’s goal timeframe.
7. Documents every incoming call during the course of the call with pertinent details (i.e., caller name, contact info, reason for call, action taken, resolution, etc.,) to ensure quality.
8. Make all attempts to resolve all member disenrollment/cancellation requests, complaint/grievances, escalating access to care issues to Network and UM to facilitate the member’s access to care issue.
9. Assist with Member Outreach programs and implementations as needed.
10. Foster good corporate relations by practicing good customer service principles (i.e., positive attitude, helpful, etc.).
11. Perform other duties as assigned by Department Management.
Supervisory Responsibilities
This job has no supervisory responsibilities.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Education and/or Experience: High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
2. Certificates, Licenses, Registrations: None required.
3. Other Qualifications:
a. Two years customer service/telemarketing experience; or
Medical front office experience.
Alignment Healthcare

b. Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans, preferred.
c. Bilingual (English/Spanish), preferred.
Skills and Abilities
1. Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
2. Mathematical Skills: Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
3. Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
4. Computer Skills: Strong computer skills.
5. Other Skills and Abilities:
a. Computer literate, typing 40+ words per minute.
b. Excellent communication skills, oral and written.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear.
2. The employee is frequently required to walk; stand; reach with hands and arms.
3. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl.
4. The employee must occasionally lift and/or move up to 20 pounds.
5. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Working Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. The noise level in the work environment is usually moderate.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.

City: Remote - CA

State: California

Location City: Remote - CA

Location State: California

Community / Marketing Title: Member Experience Associate (Temporary)

Company Profile:

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

EEO Employer Verbiage:

Alignment requires all new hires to follow local and/or state requirements regarding the COVID-19 vaccine and booster.  If applicable, proof of vaccination and booster will be required as a condition of employment subject to legal exemptions.  This policy, which Alignment reserves the right to modify, is part of Alignment’s ongoing efforts to ensure the safety and well-being of its staff and community and to support public health efforts.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Healthcare and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Healthcare and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healthcare’s talent acquisition team, please email careers@ahcusa.com.