Hybrid-Customer Experience Lead

Overview

Alignment Health is committed to serving seniors and those who need it most. The hybrid Member Experience & Engagement Lead is a subject matter expert in the health care experience our members navigate daily. This role supports the inbound and/or outbound call experience while also assisting and accelerating the performance of their team unit.
Responsibilities

Acts as subject matter expert for procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries.
Leads any specific projects, products, regions, or other specializations as assigned, including complex or VIP member issues.
Assumes the tier two 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.
Addresses 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.
Collaborates with the Trainer and QA Specialist in identifying training needs; participates in regular meetings with management to report call trends and identify opportunities for team improvement.
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.
Experience Requirements

Minimum three (3) years of customer service experience.
Preferred: five (5) or more years of customer service experience.
Healthcare experience.
Previous lead experience.
Education Requirements

High School Diploma or GED required.
College courses preferred.
Specialized Skills

Knowledge of Medicare Managed Care Plans.
Type 40+ words per minute and ability/experience with 10-key by touch.
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
Effective written and oral communication skills; ability to establish and maintain constructive relationships with diverse members, management, employees and vendors.
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.
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.
Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
Problem‑Solving Skills

Effective problem solving, organizational and time management skills and ability to work in a fast‑paced environment.
Preferred: bilingual (English/Spanish).
Pay and Benefits

Pay Range: $44,790.00 - $67,185.00
Equal Opportunity

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.

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