Member Engagement Lead

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.

Position Summary:
The Member Experience/Engagement Lead is a subject matter expert in the health care experience our members navigate daily. This ‘working’ role supports the inbound and/or outbound call experience while also assisting and accelerating the performance of their team unit.

General Duties/Responsibilities (May Include But Are Not Limited to):
• Answer incoming member phone calls within the department’s goal time frame, and conduct outbound member phone calls in accordance with the department’s productivity metrics and goals
• Be knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries
• Serve as a “subject matter expert” to support assigned team with day-to-day questions
• Lead any specific projects, products, regions, or other specializations as assigned, including complex or VIP member issues
• Address complaints against the health plan and its contracted facilities according to applicable complaint or grievance procedure
• Assist with the onboarding of entry level staff including but not limited to ‘nesting’ and quality assurance of live call monitoring during the training period as required
• Assist with coaching and training for new process implementation
• Assist in monitoring performance and productivity standards
• Maintain confidentiality and uphold standards for privacy, data integrity, and security
• Encourage a spirit of cooperation, teamwork, and accountability among all department employees
• Perform other duties as assigned

Supervisory requirements
Supports the oversight of the day-to-day operations and performance of the call agents.

Minimum Requirements

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.

Minimum Experience:
a. Three to five years customer service experience required
2. Education/Licensure:
a. High school diploma or general education degree (GED); and three to five years related experience and/or training; or equivalent combination of education and experience.
3. Other:
a. Knowledge of Medicare Managed Care Plans required
b. Previous Lead experience preferred, or similar capacity
c. Bi-lingual (English/Spanish) preferred
d. 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.
e. 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.
f. 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.
g. Computer Skills: Strong computer skills.
h. Other Skills and Abilities:
i. Excellent communication skills.
ii. Strong writing skills
iii. Excellent telephone techniques.
iv. Excellent data entry.
v. Strong organizational skills.
vi. Type 40 words per minute.
vii. Experience with 10-key by touch.
4. Work Environment:
a. 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.
i. The noise level in the work environment is usually moderate.

Essential Physical Functions:
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.

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.

Salary : $39,300 - $49,800