Job Overview
Location
Anywhere in the U.S.
Job Type
Full-time
Category
Operations
Date Posted
May 20, 2026
Full Job Description
đź“‹ Description
- • The Resolution Specialist role at Alignment Healthcare is critical to ensuring seniors and chronically ill members receive compassionate, accurate, and timely resolution of complex healthcare issues, directly supporting the company’s mission to put the senior first and improve member outcomes.
- • Day to day, the specialist manages assigned member cases from intake to closure, conducts proactive outbound outreach and handles inbound contacts to resolve concerns related to claims, authorizations, benefits, provider access, and service experience, while maintaining detailed documentation and collaborating across internal and external teams.
- • The role operates within Alignment Health’s Customer Resolution team, a mission-driven group dedicated to transforming senior healthcare through caring connections, operational excellence, and continuous improvement in a fast-growing, innovative organization focused on Medicare Advantage and managed care populations.
- • In this role, the individual will develop deep expertise in healthcare navigation, regulatory compliance (including CMS standards), case management, and cross-functional problem-solving, while building strong communication, empathy, and analytical skills that support career growth in member services, healthcare operations, or patient advocacy.
🎯 Requirements
- • Minimum 1 year of healthcare experience.
- • Minimum 1 year of contact center experience involving complex problem solving, escalation handling, or issue resolution.
- • Experience assisting members with navigating healthcare services including referrals, authorizations, claims, or benefits.
- • Ability to clearly explain health plan coverage, benefits, and services to members.
- • Strong verbal and written communication skills with the ability to build trust and rapport with members and partners.
- • Intermediate proficiency in Microsoft Office Suite (Outlook, Word, Excel).
🏖️ Benefits
- • Opportunity to do meaningful work that improves and saves lives of seniors and chronically ill members.
- • Ample room for growth and innovation within a fast-growing, mission-driven company.
- • Support for team learning and development through coaching, quality reviews, training initiatives, and knowledge sharing.
- • Ability to assist with onboarding and mentoring of new hires through shadowing or peer support.
- • Commitment to Equal Employment Opportunity and Affirmative Action, fostering a diverse and inclusive workplace.
Skills & Technologies
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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