Job description

• Opportunity: Regular, Full-time, Direct Hire
• Compensation: Flexible / Negotiable depending on skills and experience
• Benefits: Medical, Dental, Vision, 15 days PTO, 8 paid holidays, 401k + match and more!
• Training Schedule: First (4) weeks, Mon-Fri, Approximately between 11am-9pm Eastern Time

****This position will initially begin as remote / work from home until an office space has been selected in Durham, NC. Eventually, individuals hired will be required to work 100% onsite (approx, Sept 2023.) Location address is to-be-determined (TBD.)****

Work Schedule:

• Must be available Monday through Friday, 8 hours / day, 40 hours / week
• Must be available between 11am-11pm Eastern
• Must be willing to work weekends (on rotation) from October through March annually.
• Must be willing to work holidays (on rotation)
• Must be willing to work overtime from October through March annually.

No Time Off Approved:

• During first (4) weeks of training
• Entire month of January (annually)

Must…

• Have customer service experience
• Have call center experience
• Have health plan experience (highly preferred!)
• Be able to type a minimum of 35 words per minute (WPM)
• Have high speed internet
• Have designated space to work with minimal distractions

Apply directly by clicking or copy/paste into your browser: http://gr.8job.co/qUQrwx5M

Alignment Health 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 Health is committed to transforming healthcare one person at a time.

When you become a part of the Alignment Health team, you get to provide members with the quality 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 fast-growing company, you will find ample room for growth and innovation within Alignment Health .

Alignment Healthcare is seeking a passionate, highly motivated, and detail-oriented member services representative to join the member experience team. As a member services representative, you get to come alongside plan members and provide support for their concerns or complaints and as well as provides the necessary information and education to resolve concerns. If you have a strong desire to learn and grow, make an impact in the lives of seniors, and be a part of a growing organization, we are looking for you!

Why join Alignment Health? See for yourself: https://vimeo.com/216236380

General Duties and Responsibilities
(May include but are not limited to)

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

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

• 3 months related experience and / or training; or equivalent combination of education and experience.
• 2 years' customer service, telemarketing, call center, contact center experience.
• Medical front office experience a plus.
• Direct sales or related experience, preferably in the Medi-Cal, Commercial, or Medicare Managed Care industry a plus.

Education / Licensure

• 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 (AA) degree (preferred).

Other:

• Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans.
• Bilingual English and one of the below:
• Chinese
• Spanish
• Vietnamese
• Minimum typing speed of 40+ words per minute (WPM) required
• 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.

Work Environment

• Must have internet access, be able to connect to the internet hardwire for connectivity purposes and be willing and able to provide proof of internet access. (Note: Equipment is provided)
• 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.

Scheduling Requirements - Must be available and willing to work:

• Monday through Friday
• Available to work eight (8) hour shifts
• Available to work between hours of 11am - 11pm Eastern Time.
• Full time for minimally forty (40) hours per week
• Willing to work weekend shifts (Saturday and / or Sunday) on a rotational basis, as needed, and annually between October through March during open enrollment.
• Willing to work overtime (with commensurate overtime pay) as needed.
• Participate in paid training, remotely, Monday-Friday during first 6-weeks, from (approximately) 11am-9pm Eastern Time.

Opportunities:

• Careers: http://bit.ly/AHC_Career

Learn more about us:

• Our Vision: http://bit.ly/AHC_OurVision
• Newsroom: http://bit.ly/AHC_Newsroom
• CareAnywhere: http://bit.ly/AHC_CAW
• 24/7 Access to Care: http://bit.ly/AHC_247_AccesstoCare
• Why Join the Clinical Team: http://bit.ly/AHC_ClinicalTeam
• Vivify - Home Health Monitoring: http://bit.ly/AHC_VivifyHomeHealth
• Access On-Demand Concierge: https://bit.ly/ACCESSConcierge

Read about our exciting growth:

• Forbes: http://bit.ly/AHC_Forbes
• BusinessWire: http://bit.ly/AHC_BusinessWire
• Alignment's Website: http://bit.ly/AHC_Expansion

Follow us on:

• LinkedIn: http://bit.ly/Alignment_LinkedIn
• Instagram: http://bit.ly/AHC_Instagram
• Facebook: http://bit.ly/AHC_Facebook

Job Types: Full-time, Permanent

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance
• Work from home

Weekly day range:

• Monday to Friday
• Rotating weekends
• Weekend availability

Work setting:

• Call center
• Hybrid remote
• Temporarily remote

Application Question(s):

• Are you willing to work weekends on rotation between October through March annually?
• Are you willing to work holidays on rotation (except Thanksgiving and Christmas)?
• How many words per minute (WPM) are you able to type? (If you don't know, you can check on https://www.typingtest.com/)
• Do you have internet connection in your home (Yes or No)?
• Are you fully available to work anytime between 11am-11pm Eastern Time?

Experience:

• Customer service: 1 year (Required)
• Call center: 1 year (Preferred)
• Medicare, Medi-Cal, Health Plan: 1 year (Preferred)
• Microsoft Office (Word, Excel, Outlook, Teams): 1 year (Required)

Language:

• Spanish, Chinese, Vietnamese, or Korean (Preferred)

Shift availability:

• Day Shift (Preferred)
• Night Shift (Preferred)

Work Location: Hybrid remote in Durham, NC 27701

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