Member Experience Lead
Location: Orange, California US
Job Number: 1810
Position Title: Member Services Unit Lead
Alignment Healthcare is seeking a member experience lead to assist the member experience call center team in obtaining proper plan information for our members, internal staff, and providers. As the lead, you will assist in ensuring team members possess the skills and training necessary through daily performance monitoring as it pertains to the production, quality, and service to ensure that company goals and departmental metrics are met.
Essential Duties and Responsibilities
May include but are not limited to:
- Assist in monitoring performance and productivity standards specific to those systems that must be in place to serve Alignment Healthcare’s enrolled population.
- Assist with recruitment, providing feedback on identified candidates, and training of new team members.
- Assist in ensuring that employed staff possess the skills and training necessary to communicate effectively with the plan’s membership and providers.
- Collaborate with the trainer and QA specialist in the development of training programs with direct effect towards the department.
- Monitor the daily process of all member regular and retro PCP transfers and ensure that the staff reports all changes to the affected providers daily.
- Monitor queue performance, ensuring that all member experience staff answer the incoming phone calls within the goal marks set. Accept overload of incoming phone calls and assist all callers requesting to speak to a Supervisor.
- Responsible for the daily review of agent performance reports and weekly / monthly reporting of departmental queue stat reports for all AHC markets.
- Maintain confidentiality and upholds standards for privacy and data integrity and security of the member experience associates telephone calls monitored and / or evaluated.
- Encourage a spirit of cooperation, teamwork, and accountability among all department employees.
- Perform other duties as assigned.
- Assists with overseeing day to day operations and performance of the member experience associates.
- Carry out leadership responsibilities in accordance with organization policies and applicable laws.
- Responsibilities include planning, assigning and monitoring work; assisting in the rewarding assigned employees as needed or required.
- Addresses complaints and resolves problems as they pertain to as necessary.
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.
- Education and / or Experience: High school diploma or general education degree (GED); and minimum 3 years' related experience and / or training; or equivalent combination of education and experience.
- Certificates, Licenses, Registrations: None required.
- Other Qualifications:
- Knowledge of Medicare Managed Care Plans required.
- Minimum 3 years’ customer service experience required.
- Previous leadership experience required; and / or similar leadership capacity.
- Bi-lingual (English / Spanish) required.
Skills and Abilities
- 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 uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations.
- Computer Skills: Strong computer skills.
- Other Skills and Abilities:
- Excellent communication skills
- Strong writing skills
- Excellent telephone techniques
- Excellent data entry
- Strong organizational skills
- Type minimum 40 words per minute
- Experience with 10-key by touch.
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 sit; use hands to finger, handle, or feel and talk or hear.
- The employee is frequently required to walk; stand; reach with hands and arms.
- The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl.
- The employee must occasionally lift and / or move up to 20 pounds.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
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.
- The noise level in the work environment is usually moderate.
Location City: Orange
Location State: California
Community / Marketing Title: Member Experience Lead
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.
We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.