Bilingual Spanish Member Experience Associate

Job Number: 6887

Workplace Type: Fully Remote

Position Title: Member Experience Associate

Alignment Health is seeking a passionate, highly motivated, and detail-oriented bilingual Spanish member experience associate to join the 24/7-remote member experience team. The member experience associate will go above-and-beyond to assist Alignment Health Plan members with their concerns or complaints and provide the necessary information and education to resolve issues. If you are wanting to learn and grow, be part of an expanding healthcare organization, and are passionate about positively impacting the lives of seniors, we're looking for YOU!

* This is a remote, healthcare, high-volume contact center.

• Explain plan’s procedures, protocols, benefits, services, and any other necessary information to the members who call or visit the member experience department.
• Facilitate member requests for changes with network provider changes, transportation requests, or any other member request for assistance as appropriate.
• Answer all incoming member phone calls within the department’s goal time frame.
• Document every incoming call during the call with pertinent details (i.e., caller name, contact info, reason for call, action taken, resolution, etc.)
• Respond to complaints against the health plan and its contracted facilities by utilizing the departments complaint / grievance policy and procedure.
• Make all attempts to resolve all member dis-enrollment / cancellation requests, complaint / grievances, and assist the member with their questions or concerns and following up as appropriate.
• Assist with member outreach programs and implementations as needed.
• Foster good corporate relations by practicing good customer service principles (positive attitude, helpful, etc.)
• Perform other duties as assigned by manager.

• Minimum 3 months' related experience and / or training; or equivalent combination of education and experience.
• Minimum 2 years' customer service / telemarketing experience.
• Medical front office experience preferred.
• Direct sales or related experience, preferably in the Medi-Cal, Commercial, or Medicare Managed Care industry.
• High school diploma or general education degree (GED); one to three months related experience and / or training; or equivalent combination of education and experience.
• Associate degree (AA) degree (preferred).
• Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans.
• Bilingual English and Spanish required. Willing to consider Chinese (Mandarin), Vietnamese, Korean.
• Language skills:
  Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. 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 verbal instructions. Able to deal with problems involving a few concrete variables in standardized situations.
• Computer skills:
  Strong computer skills.
• Proficient in Microsoft Office (Outlook, Word, Excel)
• Able to type minimum 35 words per minute (WPM), 10-key by touch.

• Must be willing and able to be scheduled 24/7 as the member experience department is a 24/7 fully operating contact center (including evenings, overnights, weekends, and holidays.)
• Workforce management (WFM) will provide available shifts during the 4th week of training and supervisors will assign shifts to agents.
• While the leadership team will make every effort to collaborate with workforce management to take agent schedule preference into consideration, the department is unable to guarantee a set schedule shift or hours.
• Once a shift has been assigned, it will (for the most part) remain the same, taking into consideration:
• Shifts are based on business need, based on WFM assessment of…