Member Experience Lead

Location: Orange, California US

Notice

This position is no longer open.

Job Number: 2946

Workplace Type: Office Full-Time

Position Title: Member Experience Lead

External Description:

Member Experience Lead

Alignment Healthcare 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 is committed to transforming health care one person at a time.
By becoming a part of the Alignment Healthcare team, you will provide members with the quality of 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 alongside the Alignment community.
POSITION SUMMARY:
The Member Experience/Engagement Lead is a subject matter expert in the health care experience our members navigate daily. This ‘working’ role supports the inbound and/or outbound call experience while also assisting and accelerating the performance of their team unit. The Lead helps ensure team members possess the skills and training necessary through daily performance monitoring as it pertains to production, quality, and service to ensure that company goals and departmental metrics are met.

GENERAL DUTIES/RESPONSIBILITIES (MAY 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” to support assigned team with day-to-day questions
• Lead any specific projects, products, regions, or other specializations as assigned, including complex or VIP member issues
• Assumes a ‘working’ role that includes answering incoming member phone calls within the department’s goal time frame, and conducting outbound member phone calls in accordance with the department’s productivity metrics and goals
• Address complaints against the health plan and its contracted facilities according to applicable complaint or grievance procedure
• Assists in defining and monitoring performance and productivity standards
• Assists with the onboarding of entry level staff including but not limited to ‘nesting’ and quality assurance of live call monitoring during the training period as required
• Collaborate with the Trainer and QA Specialist in identifying training needs; participate in regular meetings with management to report call trends and identify opportunities for team improvement
• Assists with the daily process of all member regular and retro PCP transfers, ensuring that ‘supervisor’ approval is appropriate according to workflow
• Assists with monitoring attendance and schedule adherence
• Maintains confidentiality and upholds standards for privacy, data integrity, and security
• Encourages a spirit of cooperation, teamwork, and accountability among all department employees
• Performs other duties as assigned
SUPERVISORY REQUIREMENTS:
Supports the oversight of the day-to-day operations and performance of the call agents. Assists with the supervisory responsibilities of planning, assigning, and monitoring work; assists in the rewarding and disciplining of assigned employees as needed or required. Addresses complaints and resolves problems as necessary.
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.

1. Minimum Experience:
a. Three to five years customer service experience required
2. Education/Licensure:
a. 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.
3. Other:
a. Knowledge of Medicare Managed Care Plans required
b. Previous Lead experience required, or similar capacity
c. Bi-lingual (English/Spanish) preferred
d. 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.
e. 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.
f. 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.
g. Computer Skills: Strong computer skills.
h. Other Skills and Abilities:
i. Excellent communication skills.
ii. Strong writing skills
iii. Excellent telephone techniques.
iv. Excellent data entry.
v. Strong organizational skills.
vi. Type 40+ words per minute.
vii. Experience with 10-key by touch.
4. Work Environment:
a. 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.
i. The noise level in the work environment is usually moderate.
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.

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.
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 [email protected].

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Member Experience Lead

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].