Senior Member Services Representative

Central California Alliance For Health Hayes Valley, CA , San Francisco, CA

Posted 2 days ago

We have an exciting opportunity to join the Alliance as a Senior Member Services Representative in the Member Services Call Center Department. This role will be full time on-site in the Mariposa, CA office.

WHAT YOU'LL BE RESPONSIBLE FOR Responds to complex member issues and acts as a technical resource for Member Services Representatives Acts as a frontline customer service representative within the Member Services Department, providing assistance to members and providers in person and on the phone Assists with special projects, as assigned WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description, and list of requirements click here. Knowledge of: Principles and practices of customer service Managed health care in a health plan environment Eligibility processes and guidelines associated with one or more of the following: the Medi-Cal program, Social Security programs, foster care, adoption assistance, and/or other public assistance programs Conflict resolution techniques Windows-based PC systems and Microsoft Word, Outlook and Excel, and database systems Ability to:

Answer telephone calls promptly and minimize delays that may lead to missed calls Act as a technical resource for Member Services Representatives De-escalate complex situations, including complaints Translate healthcare-related terminology and complex processes into simple language and step-by-step instructions when communicating with members and providers Gather and evaluate information, ask appropriate questions and utilize active listening and problem-solving skills Education and Experience: High school diploma or equivalent Four years of customer service experience in member services, health care, public assistance, human services or in a customer service or call center environment which included a minimum of two years of experience in a health care setting which involved assisting members and/or providers with eligibility processes and guidelines (an Associate's degree may substitute for one year of the general customer service experience); or an equivalent combination of education and experience may be qualifying OTHER INFORMATION We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.

In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location). Mariposa County Pay Range $22.14-$35.43 USD OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

Medical, Dental and Vision Plans Ample Paid Time Off 12 Paid Holidays per year 401(a) Retirement Plan 457 Deferred Compensation Plan Robust Health and Wellness Program Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet . The Alliance is an equal employment opportunity employer.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.


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Senior Member Services Representative

Central California Alliance For Health