Partner Experience Representative

Alignment Health is breaking the mold in conventional health care committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people united in our mission to put the senior first. 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 Health community. Working at Alignment Health provides an opportunity to do work that really matters not only changing lives but saving them. Together.

GENERAL DUTIES/RESPONSIBILITIES
1. Answers incoming broker support queue phone calls from contracted Agents during our Hours of operation Monday through Friday. Schedule can vary from 8:00am to 6:00pm. These hours shall be defined as Normal Business Hours. Some weekends required.
2. Ensures that the Partner Experience Queue meets all defined service levels and that appropriate coverage is made during break or meal periods. This position ensures that all calls are coded or wrapped up correctly and that proper reports are generated to ensure service levels. Codes include the following: RX issues general benefits application issues payment commission issues packet orders trainings and tests verification of Part A and B verification of Medi-Cal network lookup and provider issues.
3. Prompts e-mail of phone follow-up as needed with established brokers to ensure satisfaction respond to queries solicit further sales (referrals) and solve or refer problems to appropriate internal AHP departments or external partners like Florida Blue and Humana in North Carolina.
4. Identifies nature of broker call and refer to the appropriate department for resolution if out of basic scope of knowledge as listed above. Works to resolve situations with Member Services Department and Eligibility to triage broker issues as they relate to member.
5. Logs calls into with Date of call Caller name nature of the issue and resolution status.
6. Conducts monthly verification of Agent licensure on the DOI website to ensure that each broker that is active. Notates this in the broker file.
7. Makes outbound calls to Brokers as necessary for reservations confirmations and communication regarding events as well as any other information.
8. Coordinates the venue for FMO meeting training and events. Maintains the attendance RSVP list of all active brokers who attend training meetings.
9. Creates and maintains all Sub-Agent files and Correct Certification and Re-Certification exams. Ride Along evaluations exams and current Life licensure must be filed for each broker that participates in
10. During Annual Election Period (AEP) as well as during downtime the broker-based responsibilities will be primary with data entry as secondary.
11. Other duties as assigned.

Job Requirements:

Experience:

Required: Minimum One (1) year of customer service/telemarketing experience.

Sales or related experience preferably in the Medi-Cal Commercial or Medicare Managed Care industry.

Preferred: Customer service in the Healthcare or insurance industry.

Education:

Required: High School Diploma or GED.

Preferred: College courses.

Specialized Skills:

Required:

• Knowledge of Medi-Cal Commercial and Medicare Managed Care Plans.
• Solid computer skills (Word Excel PowerPoint Salesforce CRM).
• Ability to communicate positively professionally and effectively with others; provide leadership teach and collaborate with others.
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members management employees and vendors;
• Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
• Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems collect data establish facts draw valid conclusions and design implement and manage appropriate resolution.
• Problem-Solving Skills: Effective problem solving organizational and time management skills and ability to work in a fast-paced environment.

Preferred: Bilingual (English/Spanish) preferred.

Licensure:

Required: None

Work 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.

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 talk and listen.

2 The employee regularly is required to sit for long period of time during Annual Enrollment Period.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability age protected veteran status gender identity or sexual orientation.

*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal be advised that Alignment Health 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 you feel that you have been the victim of a scam such as this please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healths talent acquisition team please email.