Quality Retention Specialist, Chinese – Mandarin Speaker

🔥 5 minutes ago

🇺🇸 United States – Remote

💵 $41.5k - $62.2k / year

⏰ Full Time

🟢 Junior

🔄 Customer Retention Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

🛡️ Insurance

🏥 Healthcare

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Serve as a subject matter expert for escalated member calls involving disenrollment risk • Resolve escalations using knowledge of healthcare, authorizations, claims, provider network issues, processes, and protocols • Identify process improvement opportunities within the Member Engagement department • Meet and exceed assigned monthly goals • Provide expert information about procedures, protocols, benefits, and services • Conduct outbound and receive inbound calls within department goal timeframes • Adapt communications to members' preferences, including time of day, channel, and language; use interpreter services as needed • Collaborate with other departments, supplemental benefit vendors, and provider networks to facilitate the member experience • Share best practices and participate in team meetings and training • Provide outbound support for PCP/IPA terminations • Ensure information and assistance comply with applicable federal/state laws, regulations, and health plan requirements • Document interactions in real time and complete timely wrap-up in required systems/applications • Accurately enter member demographics and information to support outcomes reporting and organizational data quality • Participate in required meetings and training concerning company processes, health plan benefit packages, and CMS • Assist with development and training of new hires, including shadowing • Support other assigned projects and duties

🎯 Requirements

• 1+ year of healthcare experience • 1+ year experience with Medi-Cal, Commercial, and Medicare Managed Care Plans and/or Sales, Customer Service, or Membership and Eligibility • High School Diploma or GED required • Bachelor's degree or four years additional experience in lieu of education • Solid knowledge and understanding of the Medicare Managed Care Manual Chapter 2 - Medicare Advantage Enrollment and Disenrollment and Medicare Communications and Marketing Guidelines • Effective written and oral communication skills • Ability to troubleshoot and problem-solve • Organizational and time management skills; ability to work in a fast-paced environment • Ability to read and interpret safety rules, operating and maintenance instructions, and procedure manuals • Ability to write routine reports and correspondence and speak effectively before groups • Basic mathematical skills involving two-digit numbers, American money, and measurements • Ability to apply common sense to detailed written or oral instructions and handle standardized problems • Ability to regularly talk, hear, stand, walk, sit, use hands and fingers, handle or feel objects, reach with hands and arms • Ability to frequently lift and/or move up to 10 pounds • Preferred experience helping members navigate access to care through Medicare Advantage or HMO, including referrals, authorizations, prescription drugs, and supplemental benefits • Bilingual in Spanish, Vietnamese, Mandarin, Cantonese, or Korean preferred • Sales License or completion of Alignment Health Plan sales certification preferred

🏖️ Benefits

• Fully remote work arrangement • Opportunity for growth and innovation • Equal Opportunity/Affirmative Action employment