Member Experience Associate

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.

At Alignment Health our mission is simple but powerful: to change senior health care. one person at a time!

Bilingual in Spanish preferred!

Training Schedule:

Monday -Friday 8:00 AM to 5:00 PM (PST) for the first 5 weeks of employment.

Post-Training Work Schedule:
After training is completed shifts will be assigned. Candidates must have full availability and be able to work any of the following shifts.

All shifts below are PST:

• 8:00 AM 4:30 PM.
• 9:00 AM 5:00 PM.
• 9:00 AM - 5:30 P.M.
• 10:00 AM - 6:30 P.M.
• 11:00 AM - 7:30 P.M.
• 3:00 P.M. - 12:00 A.M.

*Overnight shifts may be added as business needs change.

GENERAL DUTIES/RESPONSIBILITIES

• Explain plans 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.
• 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 (i.e. positive attitude helpful etc.)
• Perform other duties as assigned by manager.

JOB REQUIREMENTS:
Experience:
Required: Minimum two (2) years customer service/telemarketing experience. 1 year Medical front office experience. 1 year direct sales or related experience preferably in the Medi-Cal Commercial or Medicare Managed Care industry.
Education:
Required: High School Diploma or GED.
Preferred: Associates Degree
Specialized Skills:
Required:
Knowledge of Medi-Cal Commercial and Medicare Managed Care Plans.
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 10s and 100s. 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.
Microsoft Office Suite intermediate skills
Preferred:
Bilingual (English / Spanish) preferred.
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 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.
6. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
7. The noise level in the work environment is usually moderate.

Pay range may be based on a number of factors including market location education responsibilities experience etc.

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.