Job Number6758Workplace Type : Fully RemoteRemote - CA,California

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.

Overview of the Role :

Alignment Health is seeking a passionate and customer service oriented, remote bilingual Chinese concierge navigator advocate to join the member engagement team.

As a concierge navigator advocate, you provide outreach and support to ensure all our members have access to the care they deserve.

You will navigate our members through their health care and benefits, and connect the dots between our provider network, health plan operations, and supplemental vendors.

You will be alongside our members every step of the way to ensure they are never alone in their healthcare journey. If you are looking for an opportunity to be a part of a team making a positive impact in the lives of seniors, we're looking for you!

Responsibilities :

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.

Conduct member outreach phone calls and / or receiving inbound phone calls within the department’s goal timeframe; manage to the member’s communication preferences as possible, which may include time of day, channel, and language;

utilize interpreter service as needed.

• Collaborate with our partners including but not limited to other departments, supplemental benefit vendors, and provider network to facilitate the member experience.
• Identify members targeted for care gaps and other campaigns, and connect members to programs or services when appropriate;

analyze available programs, determine program eligibility, and connect member to appropriate provider or vendor.

Conduct real-time documentation and timely wrap-up to support outcomes reporting in all systems / applications as required;

must enter member demographics and information with accuracy and attention to detail, feel responsibility for the quality of our organizational data.

• Meet and / or exceed individual and team goals, and for submitting activity reports in the format and frequency required.
• Provide customer service and contribute to a culture of going above and beyond to ensure the highest level of member satisfaction.
• Participate in all required team meetings and trainings, and exhibit satisfactory understanding of new information and process.
• Adhere to all applicable attendance and productivity policies.
• Support other projects and duties as assigned by management

Required Skills and Experience :

• Experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations.
• Experience helping members navigate their Medicare Advantage benefits including medical, prescription drug, and supplemental benefits
• Outbound call center experience which may include welcome / onboarding, appointment scheduling, retention, sales, or other health care / health plan related programs;

and / or inbound call center experience that indicates a higher level of problem-solving such as escalation or resolution

• High school diploma or general education degree (GED); two to three years related experience and / or training; or equivalent combination of education and experience.
• Bilingual English / Chinese
• Motivated self-starter who can prioritize work assignments and make every day a productive day
• Team player willing to help and support colleagues, and do their part to support us all reaching our organizational goals
• Natural teacher with the ability to learn plans and describe / explain / educate healthcare coverage and services to our members
• Genuine passion for customer service
• Possess strong computer skills.
• Familiar with Microsoft Office (Outlook, Word, Excel)
• Able to type minimum (40) words per minute (WPM)
• Excellent written, and verbal communication skills.

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 oral instructions.

Able to deal with problems involving a few concrete variables in standardized situations.

Must be able and willing to work full-time and over-time annually through the Annual Enrollment Period (October - December) and Open Enrollment Period (January - March)

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.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls;

and reach with hands and arms.

The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay range : $41,600 - $52,000 Annually

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 # / .

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 careers@.

Last updated : 2024-06-23