Job Overview
Location
Remote Arizona
Job Type
Full-time
Category
Operations
Date Posted
July 16, 2026
Full Job Description
đź“‹ Description
- • Provides in-market, specialized member support in respective market or region.
- • Conducts in-market member engagement including Welcome Calls, New Member Onboarding, JSA Scheduling, High Quality PCP and Provider Terms, Product/Vendor Changes, CAHPS Proxy, Disenrollment Quality Assurance, and Proactive Service Recovery
- • Conducts case follow-ups and quality member issue resolution for all cases assigned.
- • Ensures members have access to PCP and specialists to coordinate care.
- • Educates members on gaps in care and assists with scheduling provider appointments.
- • Serves as the patient's liaison throughout the life cycle of the program by addressing program specific quality measures and adhering to company guidelines/standard operating procedures.
- • Makes appropriate and timely patient appointments, reminders, and confirmations and Mails letters and correspondence as needed.
- • Places regular/consistent outreaches to the patient.
- • Communicates with PCP with any member updates and requests.
- • Assists with obtaining medical records from any healthcare providers involved in care or hospitals.
- • Helps members with any authorizations and referrals involved in their care plan.
- • Resolves incoming calls concerning members’ eligibility, benefits, provider information, clinical, and pharmacy needs; coordinate membership changes such as member’s primary care physician and proactively engage member with their wellness plan options.
- • Participates in on-site member engagement activities as needed, such as in-person member meetings, handling lobby calls at a retail or care center location, etc. (subject to change).
- • Other duties as assigned.
🎯 Requirements
- • Minimum 1 year of customer service experience.
- • High-volume inbound customer service experience, particularly for health plan or Medicare “Member Services” roles in health plan and supplemental benefits preferred.
- • Telemarketing and/or member outreach experience preferred.
- • Specialized experience in escalation or resolution units preferred.
🏖️ Benefits
- • Competitive pay range: $44,790.00 - $67,185.00.
- • Opportunity to work in a fast-paced environment.
- • Ability to make a meaningful impact on the lives of seniors and those who need it most.
- • Alignment Health is an Equal Opportunity/Affirmative Action Employer.
- • All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
đź“Ť Location
- • Remote Arizona.
- • 100% remote job.
- • Operations
- • Operations
- • 0.95
- • The job title 'Remote Customer Service Rep (Bilingual in Spanish)' and the description of the role as a customer service representative with a focus on member support and engagement aligns with the category 'Operations'.
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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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