Overview of the Role:
Alignment Health is seeking a passionate, highly motivated, and detail-oriented member experience associate to join the 24/7-remote member experience team. The member experience associate will go above-and-beyond to assist Alignment Health Plan members with their concerns or complaints and provide the necessary information and education to resolve issues. If you are wanting to learn and grow, be part of an expanding healthcare organization, and are passionate about positively impacting the lives of seniors, we're looking for YOU!
*This is a remote, healthcare, high-volume contact center.
Responsibilities:
- Explain plan’s procedures, protocols, benefits, services, and any other necessary information to the members who call or visit the member experience department.
- Facilitate member requests for changes with network provider changes, transportation requests, or any other member request for assistance as appropriate.
- Answer all incoming member phone calls within the department’s goal time frame.
- Document every incoming call during the call with pertinent details (i.e., caller name, contact info, reason for call, action taken, resolution, etc.)
- Respond to complaints against the health plan and its contracted facilities by utilizing the departments complaint / grievance policy and procedure.
- Make all attempts to resolve all member dis-enrollment / cancellation requests, complaint / grievances, and assist the member with their questions or concerns and following up as appropriate.
- Assist with member outreach programs and implementations as needed.
- Foster good corporate relations by practicing good customer service principles (positive attitude, helpful, etc.)
- Perform other duties as assigned by manager.
Required Skills & Experience:
- Minimum 3 months' related experience and / or training; or equivalent combination of education and experience.
- Minimum 2 years' customer service / telemarketing experience.
- Medical front office experience preferred.
- Direct sales or related experience, preferably in the Medi-Cal, Commercial, or Medicare Managed Care industry.
- High school diploma or general education degree (GED); one to three months related experience and / or training; or equivalent combination of education and experience.
- Associate degree (AA) degree (preferred).
- Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans.
- Bilingual English and Spanish required. Willing to consider Chinese (Mandarin), Vietnamese, Korean.
- Language skills: Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Able to speak effectively before groups of customers or employees of the organization.
- Mathematical skills: Able to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Able to perform these operations using units of American money and weight measurement, volume, and distance.
- Reasoning skills: Able to apply common sense understanding to carry out detailed but un-involved written or verbal instructions. Able to deal with problems involving a few concrete variables in standardized situations.
- Computer skills: Strong computer skills.
- Proficient in Microsoft Office (Outlook, Word, Excel)
- Able to type minimum 35 words per minute (WPM), 10-key by touch.
Work Schedule:
- Must be willing and able to be scheduled 24/7 as the member experience department is a 24/7 fully operating contact center (including evenings, overnights, weekends, and holidays.)
- Workforce management (WFM) will provide available shifts during the 4th week of training and supervisors will assign shifts to agents.
- While the leadership team will make every effort to collaborate with workforce management to take agent schedule preference into consideration, the department is unable to guarantee a set schedule shift or hours.
- Once a shift has been assigned, it will (for the most part) remain the same, taking into consideration:
- Shifts are based on business need, based on WFM assessment of coverage gaps, and language needs.
- Shifts are subject to change based on time of year, forecasted volumes, and gaps caused by attrition, etc.
- Efforts will be made to seek out volunteers before re-assigning individual(s) a shift change. However, if not enough volunteers come forward, shifts will be assigned.
Training schedule:
- Remote, paid training is provided during the first (5) weeks from Monday through Friday, 8am – 5pm Pacific Time. No time off is permitted during the (5) week training period.
No Time Off Approved During:
- No time off is permitted during the first (5) week training period.
- Annually during entire month of January due to it being the busiest time of the year (no exceptions)
Work Environment – Remote Work from Home:
- Must have a dedicated, private workspace that is quiet and free from distractions and background noise. Must make any necessary arrangements (with others in the household) to ensure ability to fully focus and perform professionally, as if in an office.
- Must have high-speed internet and able to connect hardwire to a router. The system cannot and will not work on WiFi alone. If minimum required internet speed is not met, individual may be asked to upgrade if needed Equipment and ethernet cable will be provided*
- During scheduled shift, no other tasks may be performed (ex. watching movies / TV, cleaning, providing caregiving, doing laundry, carrying on side conversations, etc.)
- Must be willing and able to be on camera throughout the duration new hire training and any future training sessions. Company will provide a webcam*
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.
- 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.
- The employee is frequently required to walk; stand; reach with hands and arms.
- The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl.
- The employee must occasionally lift and / or move up to 20 pounds.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- The noise level in the work environment is usually moderate.
United States
