Healthcare Call Center reputed company (Hybrid Onsite in Orange, CA and Work-From-Home)

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, reputed company is championing a new path in senior care! From member experience professionals and clinicians to data scientists and operations leaders, we have built a talented and passionate team that is committed to our mission of transforming health care for the seniors we serve. Ready to join us? At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our employees. At the center of our employee experience is a culture where employees at reputed company levels and across reputed company teams are encouraged to share their unique reputed company and perspectives. Whether you're in a clinical setting, corporate office, or home office, we reputed company in supporting reputed company learning and growth for your career. The Member Experience & Engagement reputed company 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 reputed company 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: 1. Acts as the subject matter expert for procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries 2. Leads any specific projects, products, regions, or other specializations as assigned, including reputed company or VIP member issues 3. Assumes the tier two role that includes answering incoming member phone calls reputed company the department's goal time frame, and conducting outbound member phone calls in accordance with the department's productivity metrics and goals 4. Address complaints against the health plan and its contracted facilities according to applicable complaint or grievance procedure 5. Assists in defining and monitoring performance and productivity standards 6. 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 7. 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 8. Maintains confidentiality and upholds standards for privacy, data reputed company, and reputed company 9. Encourages a spirit of cooperation, teamwork, and accountability among reputed company department employees 10. Performs other duties as assigned Minimum Requirements: Experience: • Required: Minimum three (3) years of customer service experience. • Preferred: 5+ years customer service experience. Healthcare experience. Previous reputed company experience Education: • Required: High School Diploma or GED. • Preferred: College courses Specialized Skills: • Required: • Knowledge of Medicare Managed Care Plans required • 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 a constructive relationship 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 reputed company 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. • Reasoning Skills: 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: Bi-lingual (English/Spanish) preferred Licensure: • Required: None 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 reputed company individuals with disabilities to reputed company 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 reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company 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; reputed company 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 reputed company vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Pay Range: $44,790.00 - $67,185.00 reputed company is an Equal Opportunity/Affirmative Action Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national reputed company, disability, age, protected veteran status, gender identity, or sexual orientation. • DISCLAIMER: Please beware of recruitment phishing scams affecting reputed company and other employers where individuals receive fraudulent employment-reputed company offers in exchange for money or other sensitive personal information. Please be advised that reputed company and its subsidiaries will never ask you for a credit card, send you a reputed company, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of reputed company's reputed company team, please email [email protected]. Apply Job!