Alignment Healthcare is a population health management company dedicated to changing the way health care is delivered in the United States. We are a fast-growing, highly dynamic organization that isn’t content with the status quo. We are looking for dedicated, innovative individuals who thrive in a fast-paced environment to join our team and help us carry out our vision - that is, to lead a movement that transformationally improves health care.

Join us today and we will give you every opportunity to succeed.

Member Services Unit Lead (Bilingual Spanish)

Location: Orange, California US

Notice

This position is no longer open.

Job Number: 1328

Position Title: Member Services Unit Lead

External Description:

The Member Services Department Unit Lead assists the Member Services Representatives in obtaining proper plan information for our members, internal staff, and providers. The Unit Lead assists in ensuring team members possess the skills and training necessary to meet goal marks established.

Essential Duties and Responsibilities:

1. Assists in defining and monitoring performance and productivity standards specific to those systems that must be in place to serve Alignment Healthcare’s enrolled population.
2. Assists in ensuring that employed staff possess the skills and training necessary to communicate effectively with the plan’s membership and providers.
3. Collaborate with the Trainer and QA Specialist in the development of training programs with direct effect towards the department.
4. Monitors the daily process of all member regular and retro PCP transfers and ensure that the staff reports all changes to the affected providers on a daily basis.
5. Monitors queue performance, ensuring that all Member Services Representatives 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.
6. Responsible for the daily review of agent performance reports and weekly/monthly reporting of departmental queue stat reports for all AHC markets.
7. Maintains confidentiality and upholds standards for privacy and data integrity and security of the Member Services Representatives telephone calls monitored and/or evaluated.
8. Performs other duties as assigned.

Supervisory Responsibilities

Assists with overseeing day to day operations and performance of the Member Service Representatives Carries out supervisory responsibilities in accordance with organization policies and applicable laws. Responsibilities include planning, assigning and monitoring work; assisting in the rewarding and disciplining of assigned employees as needed or required. Addresses complaints and resolves problems as they pertain to as necessary.

Qualifications

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.


1. Education and/or Experience: High school diploma or general education degree (GED); and three to five years related experience and/or training; or equivalent combination of education and experience.
2. Certificates, Licenses, Registrations: None required.
3. Other Qualifications:
a. Knowledge of Medicare Managed Care Plans required.
b. Three to five years customer service experience required.
c. Previous Supervisory experience required; or similar supervisory capacity.
d. Bi-lingual (English/Spanish) required.


Skills and Abilities

1. Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
2. Mathematical Skills: Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
3. Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
4. Computer Skills: Strong computer skills.
5. Other Skills and Abilities:
a. Excellent communication skills.
b. Strong writing skills
c. Excellent telephone techniques.
d. Excellent data entry.
e. Strong organizational skills.
f. Type 40+ words per minute.
g. Experience with 10-key by touch.

Physical Demands

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.

Working 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.

1. The noise level in the work environment is usually moderate.

 

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.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Member Services Unit Lead (Bilingual Spanish)

Company Profile:

Who is Alignment Healthcare?

  • Socially responsible
  • Technologically enabled
  • Concierge care
  • Transformation
  • 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.

EEO Employer Verbiage:

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 careers@ahcusa.com.

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