Virtual Concierge Navigator, Medical Asst.

Location: Remote - CA, California US

Notice

This position is no longer open.

Job Number: 2516

Workplace Type:

Position Title: Virtual Concierge Navigator, Medical Asst.

External Description:

Position Summary:

The ACCESS On-Demand Concierge is Alignment Healthcare's model to ensure best-in-class service and care coordination 24/7. As a member of this team, you will be at the center of our member experience and the face of Alignment Healthcare. You will provide members with “White Glove” service and act as a guide to help our members navigate their virtual experience and health care overall.

 

 

The Virtual Concierge Navigator ensures member satisfaction and customer service are provided at the level of excellence that our members deserve. To do so, you will become an expert on our health plan and supplemental benefits, care deliver model, and provider network; you will also serve as the liaison among members, providers, and internal departments. By ensuring an “aligned” experience is available to our members at any time of day or night, over the phone, through video-chat, and messaging.

 

 

 

Essential Duties and Responsibilities:

 

Essential duties and responsibilities of the Virtual Concierge Navigator include, but are not limited to:

 

  • Be knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries; serve as a “subject matter expert” in the health care experience that our members navigate daily.
  • Resolve incoming calls concerning members’ eligibility, benefits, provider information, clinical, and pharmacy needs; coordinate membership changes such as member’s primary care physician and proactively engage member with their wellness plan options.
  • Collaborate with our partners – including but not limited to other departments, supplemental benefit vendors, and provider network – to facilitate the member experience.
  • Responsible for receiving inbound phone calls within the department’s goal timeframe; may be required to communicate with members in other channels including e-mail, web chat, SMS/text, as required.
  • Manage to the member’s communication preferences as possible, which may include time of day, channel, and language; utilize interpreter service as needed.
  • Responsible for real-time documentation (i.e., caller name, contact info, call reason, action taken, resolution, etc.) and timely wrap-up to support outcomes reporting, in all systems/applications as required.
  • Provide administrative support to virtual providers with referrals and initiating authorization requests as deemed appropriate, following up to ensure completion.
  • Coordinates member’s care for PCP care plan, diagnostic tests, radiology, laboratory, and specialty appointments. Ensures appointments are scheduled and confirmed with the member via Alignment’s EMR system; confirms demographics entered are complete. Schedules transportation as appropriate.
  • Manage appropriate clinical escalations and triage; link the member to appropriate clinical resources.
  • Verify the member is included in or targeted for any outreach or care gap programs and connect members to programs (such as chronic disease programs) or services when appropriate. Analyze available programs, determine program eligibility, and assists with enrollment of such program as appropriate.
  • Monitor communication channels as assigned and manage replies to ensure all metrics for timeliness and member experience success are met.
  • Develop, write, and edit digital replies, which may involve coordination of health plan benefits knowledge, reference documents, member resources, insights from key stakeholders, and more to be determined.
  • Follow communication “scripts” and/or templates as appropriate, ensuring the consumers’ needs are clearly understood and resolved.
  • Excel in customer service and contribute to a culture of going “above and beyond” to ensure the highest level of member satisfaction.
  • Adhere to all applicable attendance policies to ensure consistent and reliable queue coverage, which is essential to the member experience.

 

Supervisory Responsibilities

This job has no supervisory responsibilities.

 

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).
  2. Certificates, Licenses, Registrations:  Medical Assistant Certification. Required.
  3. Other Qualifications: 
  • Medical front/back office experience.
  • Knowledge of ICD-10 and CPT codes.
  • High-volume inbound customer service experience, particularly for health plan or Medicare “Member Services” roles in health plan and supplemental benefits.
  • Telemarketing and/or member outreach experience.
  • Specialized experience in escalation or resolution units. Preferred.

 

Skills and Abilities

 

  1. Communication Skills: Strong communication skills via email and phone. Fluency in written and verbal Spanish, Korean, or Vietnamese, a plus.
  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:
    1. Computer literate, typing 40+ words per minute.
    2. Excellent communication skills, oral and written.
    3. Must pass a writing test. Impeccable grammar and spelling.

 

Please note: No time off granted during Onboarding/Training and for Jan 1 – Jan 30, 2021 due to high call volume for calendar year enrollment. Must be willing to work overnight, weekends, and holidays as scheduled.

 

 

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.
  2. Remote, work from home positions available.

City: Remote - CA

State: California

Location City: Remote - CA

Location State: California

Community / Marketing Title: Virtual Concierge Navigator, Medical Asst.

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

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 information. Please 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 company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].