Job Overview
Location
Anywhere in the U.S.
Job Type
Full-time
Category
Marketing
Date Posted
June 18, 2026
Full Job Description
đź“‹ Description
- • Serve as the subject matter expert for Medicare Managed Care Plans, providing accurate guidance on procedures, protocols, benefits, and services to resolve member inquiries and issues.
- • Lead inbound and outbound member phone calls, ensuring all calls are answered within departmental goal timeframes and meet productivity metrics.
- • Handle complex or VIP member issues, including formal complaints against the health plan and contracted facilities, following applicable grievance and complaint procedures.
- • Monitor daily team performance across production, quality, and service standards to ensure alignment with company goals and departmental KPIs.
- • Assist in onboarding and training entry-level staff through live call monitoring, nesting, and quality assurance practices during the training period.
- • Collaborate with Trainers and QA Specialists to identify skill gaps and training needs, and participate in regular management meetings to report call trends and recommend team improvements.
- • Maintain strict confidentiality and uphold standards for privacy, data integrity, and security in all member interactions and documentation.
- • Encourage a culture of teamwork, accountability, and cooperation among department employees to foster a high-performance environment.
- • Perform tier two support duties, stepping in to resolve escalated issues and provide guidance to frontline team members.
- • Manage multiple tasks simultaneously in a fast-paced environment, applying advanced problem-solving and prioritization skills to address member concerns efficiently.
- • Utilize strong written and oral communication skills to build constructive relationships with members, management, employees, and vendors.
- • Apply mathematical skills to perform calculations involving American currency, weight, volume, and distance measurements as needed for member service tasks.
- • Demonstrate ability to apply common sense understanding to follow detailed written or oral instructions and solve problems in standardized situations.
- • Maintain a typing speed of 40+ words per minute and proficiency in 10-key data entry by touch.
- • Support special projects, regional initiatives, or product rollouts as assigned by management, ensuring seamless execution and member satisfaction.
🎯 Requirements
- • Minimum three (3) years of customer service experience
- • Knowledge of Medicare Managed Care Plans required
- • High School Diploma or GED
- • Typing speed of 40+ words per minute and 10-key proficiency by touch
- • Ability to communicate positively, professionally, and effectively with diverse stakeholders
- • Strong problem-solving, organizational, and time management skills in a fast-paced environment
🏖️ Benefits
- • Pay range of $44,790.00 - $67,185.00 based on market location, experience, and responsibilities
- • Remote work opportunity anywhere in the U.S.
- • Employment with a mission-driven organization focused on serving seniors and chronically ill members
- • Equal Opportunity/Affirmative Action employer offering inclusive hiring practices
Skills & Technologies
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About Alignment Healthcare, LLC
Alignment Healthcare is a health insurance company that focuses on providing personalized care for seniors and underserved populations. They operate a value-based care model, aiming to improve health outcomes and reduce costs through integrated care teams, technology, and data analytics. Their services include Medicare Advantage plans, chronic care management, and home-based care. Alignment Healthcare partners with providers and aims to deliver a seamless and high-quality healthcare experience for its members, emphasizing proactive and preventive care to keep individuals healthy and out of the hospital.
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