Concierge Lead at Alignment Healthcare USA, LLC in Orange, California

Job Description:

Concierge Lead

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. 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 community.

Summary

The Member Experience Concierge Lead is a subject matter expert in the health care experience our members navigate daily. This 'working' role 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.

Essential Duties and Responsibilities
(May include but are not limited to:)

1. Be knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries
2. Serve as a "subject matter expert" to support assigned team with day-to-day questions
3. Lead any specific projects, products, regions, or other specializations as assigned, including complex or VIP member issues
4. Assume a 'working' 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
5. Address complaints against the health plan and its contracted facilities according to applicable complaint or grievance procedure
6. Assist in defining and monitoring performance and productivity standards
7. Assist 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
8. Collaborate 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
9. Assist with the daily process of all member regular and retro PCP transfers, ensuring that 'supervisor' approval is appropriate according to workflow
10. Assist with monitoring attendance and schedule adherence
11. Maintain confidentiality and upholds standards for privacy, data integrity, and security
12. Encourage a spirit of cooperation, teamwork, and accountability among all department employees
13. Perform other duties as assigned

Supports the oversight of the day-to-day operations and performance of the call agents. Assists with the supervisory responsibilities of planning, assigning, and monitoring work; assists in the rewarding and disciplining of assigned employees as needed or required. Addresses complaints and resolves problems as necessary.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Education and/or Experience: High school diploma or general education degree (GED); and three to five years related experience and/or training; or equivalent combination of education and experience.
2. Certificates, Licenses, Registrations: None required.
3. Other Qualifications:
   
   
   1. Knowledge of Medicare Managed Care Plans required
   2. Three to five years customer service experience required
   3. Previous Lead experience required, or similar capacity
   4. Bi-lingual (English/Spanish) preferred
   
   

1. Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
2. 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.
3. 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.
4. Computer Skills: Strong computer skills.
5. Other Skills and Abilities:
   
   
   1. Excellent communication skills.
   2. Strong writing skills
   3. Excellent telephone techniques.
   4. Excellent data entry.
   5. Strong organizational skills.
   6. Type 40+ words per minute.
   7. Experience with 10-key by touch.
   
   

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.

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.

1. The noise level in the work environment is usually moderate.