Virtual Concierge Navigator Medical Assistant

Job Number:2376

Position Title:Virtual Concierge Navigator Medical Asst.

External Description:

Virtual Concierge Navigator Medical Assistant

Position Summary:
The ACCESS OnDemand Concierge is Alignment Healthcares model to ensure bestinclass service and care coordination 24/7. As a member of this team you will be at the center of our member experience and the face of Alignment Healthcare. You will provide members with White Glove service and act as a guide to help our members navigate their virtual experience and health care overall.

The Virtual Concierge Navigator ensures member satisfaction and customer service are provided at the level of excellence that our members deserve. To do so you will become an expert on our health plan and supplemental benefits care deliver model and provider network; you will also serve as the liaison among members providers and internal departments. By ensuring an aligned experience is available to our members at any time of day or night over the phone through videochat and messaging.

Essential Duties and Responsibilities:

Essential duties and responsibilities of the Virtual Concierge Navigator include but are not limited to:

Be knowledgeable in procedures protocols benefits services and any other necessary information to resolve member issues and inquiries; serve as a subject matter expert in the health care experience that our members navigate daily.
Resolve incoming calls concerning members eligibility benefits provider information clinical and pharmacy needs; coordinate membership changes such as members primary care physician and proactively engage member with their wellness plan options.
Collaborate with our partners including but not limited to other departments supplemental benefit vendors and provider network to facilitate the member experience.
Responsible for receiving inbound phone calls within the departments goal timeframe; may be required to communicate with members in other channels including email web chat SMS/text as required.
Manage to the members communication preferences as possible which may include time of day channel and language; utilize interpreter service as needed.
Responsible for realtime documentation (i.e. caller name contact info call reason action taken resolution etc. and timely wrapup to support outcomes reporting in all systems/applications as required.
Provide administrative support to virtual providers with referrals and initiating authorization requests as deemed appropriate following up to ensure completion.
Coordinates members care for PCP care plan diagnostic tests radiology laboratory and specialty appointments. Ensures appointments are scheduled and confirmed with the member via Alignments EMR system; confirms demographics entered are complete. Schedules transportation as appropriate.
Manage appropriate clinical escalations and triage; link the member to appropriate clinical resources.
Verify the member is included in or targeted for any outreach or care gap programs and connect members to programs (such as chronic disease programs) or services when appropriate. Analyze available programs determine program eligibility and assists with enrollment of such program as appropriate.
Monitor communication channels as assigned and manage replies to ensure all metrics for timeliness and member experience success are met.
Develop write and edit digital replies which may involve coordination of health plan benefits knowledge reference documents member resources insights from key stakeholders and more to be determined.
Follow communication scripts and/or templates as appropriate ensuring the consumers needs are clearly understood and resolved.
Excel in customer service and contribute to a culture of going above and beyond to ensure the highest level of member satisfaction.
Adhere to all applicable attendance policies to ensure consistent and reliable queue coverage which is essential to the member experience.

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).
2. Certificates Licenses Registrations: Medical Assistant Certification. Required.
3. Other Qualifications:
Medical front/back office experience.
Knowledge of ICD10 and CPT codes.
Highvolume inbound customer service experience particularly for health plan or Medicare Member Services roles in health plan and supplemental benefits. Preferred.
Telemarketing and/or member outreach experience. Preferred.
Specialized experience in escalation or resolution units. Preferred.

Skills and Abilities

1. Communication Skills: Strong communication skills via email and phone. Fluency in written and verbal Spanish Korean or Vietnamese a plus.
2. 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.
3. Mathematical Skills: Ability to add and subtract two digit numbers and to multiply and divide with 10s and 100s. Ability to perform these operations using units of American money and weight measurement volume and distance.
4. 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.
5. Computer Skills: Strong computer skills.
6. Other Skills and Abilities:
a. Computer literate typing 40 words per minute.
b. Excellent communication skills oral and written.
c. Must pass a writing test. Impeccable grammar and spelling.

Please note: No time off granted during Onboarding/Training and for Jan 1 Jan 30 2021 due to high call volume for calendar year enrollment. Must be willing to work overnight weekends and holidays as scheduled.

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.
2. Remote work from home positions available.

City:Orange

State:California

Location City:Orange

Schedule:Full Time

Location State:California

Community / Marketing Title:Virtual Concierge Navigator Medical Assistant

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 fastgrowing company you will find ample room for growth and innovation alongside the Alignment community.

EEO Employer Verbiage:

On August 17 2021 Alignment implemented a policy requiring all new hires to receive the COVID19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignments ongoing efforts to ensure the safety and wellbeing of our 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 preemployment testing or otherwise participating in the employee selection process please contact