Member Engagement Lead (Orange)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most : the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. 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 Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Member Experience & Engagement Lead is a subject matter expert in the health care experience our members navigate daily. 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

• Acts as the 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 departments goal time frame, and conducting outbound member phone calls in accordance with the departments 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
• Collaborates 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
• 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

Minimum Requirements :

Education

Specialized Skills

Licensure

Work 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.

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.

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

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

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.