VP, Member Experience

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 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 (May include but are not limited to):

• Responsible for refining and executing Care Navigation strategy including customer developed CRM telecommunication platform and analytics to deliver member insights and actions.
• Leads teams focused on member experience across the Enterprise.
• Strategizes executes and manages in-house and outsourced operations to ensure optimal efficiency data integrity and service.
• Leads Appeals and Grievances program with a focus on continuous quality improvement and effectiveness.
• Analyzes results and leads Quality initiatives to reduce the number of overturned appeals and grievances.
• Seeks ways to innovate workflow process improvements and automation of the data environment while maximizing system investments and integration.
• Ensures strong customer service orientation of staff and ensures market needs are meeting stringent quality standards while ensuring efficiency and effectiveness of departments.
• Develops & implements plans to resolve and remediate quality or service issues related.
• Ensure a collaborative environment within the department and organization to facilitate solutions and optimal performance.
• Accountable for the identification and implementation of strategies to promote member engagement and retention.
• Establish and manage processes to regularly report standard metrics related to member experience.
• Requires some travel.
• Performs other related duties as assigned.
  

SUPERVISORY RESPONSIBILITIES:

• Oversees assigned staff. Responsibilities include recruiting selecting orienting and training employees; assigning workload; planning monitoring and appraising job results; and coaching counseling and disciplining employees.
• Ensure the team is structured appropriately to meet key priorities; assesses skill level to ensure team members are in the right roles supporting skill development as needed.

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:

Minimum 10 years of consumer / member experience in a healthcare environment.

5-7 years of Call Center experience.

Medicare Appeals and Grievances experience preferred

Education/Licensure:

Bachelors Degree (BA) from four-year college or university or one to two years of related experience and/or training or equivalent combination of education and experience.

Masters Degree (MA) preferred.

Other:

Demonstrated track record of generating results and having an impact on organizations.

Proven success streamlining operations and experience running efficient operations is a plus.

Strategic and forward-thinking mindset.

Strong leadership skills with the ability to develop teams.

Innovative in problem solving planning and strategizing.

Articulate & persuasive in preparing / presenting business-case for change-management including at both detailed and executive level where required.

Effective interpersonal skills to consistently demonstrate expertise business knowledge and team cohesiveness.

Excellent communication skills especially in one-on-one and small-large group settings is essential.

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.

While performing the duties of this job the employee is regularly required to talk or hear. The employee regularly is required to stand walk sit use hand to finger handle or feel objects tools or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the 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.

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.