By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply 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 over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.
Overview of the role:
The Healthcare Call Center 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.
Responsibilities:
- Knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries
- Serve as a “subject matter expert” to support assigned team with day-to-day questions
- Lead any specific projects, products, regions, or other specializations as assigned, including complex or VIP member issues
- 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
- Address complaints against the health plan and its contracted facilities according to applicable complaint or grievance procedure
- Assist in defining and monitoring performance and productivity standards
- 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
- Collaborate with trainer and QA specialist in identifying training needs; participate in regular meetings with management to report call trends and identify opportunities for team improvement
- Assist with the daily process of all member regular and retro PCP transfers, ensuring that ‘supervisor’ approval is appropriate according to workflow
- Assist with monitoring attendance and schedule adherence
- Maintain confidentiality and upholds standards for privacy, data integrity, and security
- Encourage a spirit of cooperation, teamwork, and accountability among all department employees
Supervisory responsibilities:
- Support the oversight of the day-to-day operations and performance of the call agents.
- Assist with the supervisory responsibilities of planning, assigning, and monitoring work
- Assist in the rewarding and disciplining of assigned employees as needed or required.
- Address complaints and resolves problems as necessary.
Required skills and experience:
- Three to five years customer service experience required
- 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.
- Knowledge of Medicare Managed Care Plans required
- Previous Lead experience required, or similar capacity
- Bi-lingual (English/Spanish) preferred