Supervisor, Customer Reimbursement and Digital

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $58.5k - $87.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Guide and coach a team of Customer Experience Resolution and Reimbursement Specialists • Support digital member communications and reimbursement processing • Set performance expectations for quality, turnaround time, productivity, compliance, and member satisfaction • Conduct coaching sessions, case reviews, and quality audits • Support onboarding, training, and continuous skill development • Improve workflows, reduce processing delays, and enhance member experience • Escalate regulatory or process concerns and partner with leadership on improvements • Monitor operational metrics, trends, and member satisfaction • Develop action plans to improve productivity, quality, and service outcomes • Support accurate and timely operational reporting • Ensure timely, clear, professional, and compliant responses to member inquiries • Reinforce digital adoption and efficient service-channel use • Ensure accurate CRM documentation under organizational, CMS, and regulatory requirements • Partner with Operations, Technology, Compliance, and other internal teams • Participate in cross-functional workflow and continuous-improvement initiatives • Supervise Specialists and support hiring, onboarding, coaching, performance management, recognition, and corrective action • Ensure compliance with Alignment policies, CMS regulations, and applicable laws • Report to the Director, Customer Resolution

🎯 Requirements

• 5+ years of healthcare contact center, member services, or resolution experience within a managed care organization • Familiarity with grievances, appeals, Direct Member Reimbursements, and CMS-regulated environments • High School Diploma or GED • Equivalent combination of education and experience may be considered • Working knowledge of Medicare Managed Care (Parts C and D) and CMS compliance requirements • Strong understanding of case management workflows and turnaround time management • Ability to coach for empathy, clarity, ownership, and resolution effectiveness • Ability to identify trends and root causes using performance data • Excellent written and verbal communication skills, particularly in digital channels • Strong organizational skills with the ability to manage competing priorities • Ability to balance compassion with operational rigor in a fast-paced environment • Reliable internet connectivity • Ability to manage multiple concurrent projects • Strict adherence to HIPAA and confidentiality standards • Bilingual (English/Spanish) preferred • 2+ years of supervisory or team lead experience preferred • Experience supporting Medicare Advantage populations strongly preferred

🏖️ Benefits

• Opportunity for growth and innovation • Professional development • Reasonable accommodation for individuals with disabilities • Equal employment opportunity