CXO Specialist - Alignment Healthcare

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.

Position Summary:

The CXO Specialist is a role within our Office of the Chief Experience Officer focused on providing exceptional customer service to members who require additional expertise in resolving their inquiries. This position involves promptly addressing inquiries from the escalation and service recovery channels directed to our Chief Experience Officer. As a CXO Specialist, you will play a critical role in helping our members navigate the complex healthcare system. You will act as their advocate, quickly build a rapport, listen to their concerns, and strive to resolve them efficiently. This is a role for a passionate and experienced customer service representative who understands the meaningful contribution they make to our members’ healthcare outcomes. A successful CXO Specialist possesses high emotional intelligence, is adept at handling difficult conversations/situations, is capable of acting quickly with minimal guidance, and is comfortable interacting with executive leadership.

General Duties/Responsibilities (May include but are not limited to):

·         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 healthcare experience that our members navigate daily.

·         Additional subject matter expertise as a senior-level team member in workflows, product and/or business line, region, etc.

·         Responsible for conducting member outreach phone calls and/or receiving inbound phone calls within the department’s goal timeframe; successfully contact and manage to the member’s communication preferences as possible, which may include time of day, channel, and language; multi-lingual skills and/or 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.

·         Responsible for 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 responsible for the quality of our organizational data.

·         Responsible for meeting or exceeding individual and team goals, and for submitting activity reports in the format and frequency required.

·         Excel in customer service and contribute to a culture of going “above and beyond” to ensure the highest level of member satisfaction.

·         Must participate in all required team meetings and training and exhibit satisfactory understanding of new information and process.

·         Adhere to all applicable attendance and productivity policies.

·         Assist with the development and training of new hires including shadowing and nesting.

·         Support other projects and duties as assigned by Management.

Supervisory Responsibilities:

N/A

Minimum Requirements:

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.

·         Minimum Experience:

a.       Two to three years customer service experience required

b.       Knowledge of Medicare Managed Care Plans required

c.       Bi-lingual (English/Spanish) preferred

·         Computer Skills:

a.       Intermediate MS Suite knowledge and experience

b.       Ability to troubleshoot/problem solve

·         Language Skills:

a.       Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals

b.       Ability to write routine reports and correspondence

c.       Ability to speak effectively before groups of customers or employees of the organization

·         Mathematical Skills:

a.       Ability to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s

b.       Ability to perform these operations using units of American money and weight measurement, volume, and distance

·         Reasoning Skills:

a.       Ability to apply common sense understanding to carry out detailed, but un-involved written or oral instructions

b.       Ability to deal with problems involving a few concrete variables in standardized situations

·         Education/Licensure:

a.       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

b.       Bachelor’s degree preferred

·         Other:

a.       Must be available to work full-time and over-time through the Annual Enrollment Period (Oct-Dec) and Open Enrollment Period (Jan-Mar)

·         Work Environment:

1. 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.

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.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.