Alignment Health is seeking a passionate and customer service oriented remote concierge navigator advocate for a long-term temporary engagement (with medical benefits) 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!
Please note: Alignment Health is continuing to expand so there is a possibility the engagement could extend or convert based on budget, business need, and individual performance.
Overview of the Role:
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, i.e. 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 / Spanish, or Vietnamese, Chinese (Mandarin), Korean
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.
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 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.
