FULL_TIME

FEED

OTHER

Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. 2. 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.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Remote Regional Concierge Navigator provides outreach and support to all our members, ensuring they have access to the care they deserve. Supports our members to navigate through their health care and benefits. Connects the dots between our provider network, health plan operations, and supplemental vendors. Maintains a high knowledge of the member needs of their respective market and assist our members every step of the way to ensure they are never alone in their healthcare journey and have the highest level of coordinated care. Lays the groundwork for future and ongoing member support. Has familiarity with assigned markets and understands the meaningful contributions to members' healthcare outcomes.ENERAL DUTIES/RESPONSIBILITIES 1. Provides in-market, specialized member support in respective market or region. 2. 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 3. Conducts case follow-ups and quality member issue resolution for all cases assigned. 4. Ensures members have access to PCP and specialists to coordinate care. 5. Educates members on gaps in care and assists with scheduling provider appointments. 6. 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. 7. Makes appropriate and timely patient appointments, reminders, and confirmations and Mails letters and correspondence as needed. 8. Places regular/consistent outreaches to the patient 9. Communicates with PCP with any member updates and requests. 10. Assists with obtaining medical records from any healthcare providers involved in care or hospitals. 11. Helps members with any authorizations and referrals involved in their care plan. 12. 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. 13. 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). 14. Other duties as assigned. Job Requirements: Experience: • Required: Minimum 1 year of customer service experience.• Preferred: 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. Education: • Required: High School Diploma or GED. Specialized Skills: • Required: <ul><li>Knowledge of ICD-10 and CPT codes.</li><li>Keyboard typing 40+ words per minute.</li><li>Ability to help members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations.</li><li>Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.</li><li>Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.</li><li>Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly</li><li>Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li></ul> • Preferred: Bilingual English/Spanish or English/Vietnamese or English/Mandarin. Fluency in written and verbal Spanish, Korean, or Vietnamese, a plus. Licensure: • Required: NoneWork EnvironmentThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this 100% remote job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.2 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $44,790.00 - $67,185.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. 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.*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/ . If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email careers@ahcusa.com .

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Alignment Healthcare USA, LLC

Remote Outreach Concierge Navigator (Bilingual in Spanish)

Calendar Management

Clinical Information

Communication Skills

Concrete

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

Current Procedural Terminology (CPT)

Customer Support/Service

English Language

Health Maintenance Organization (HMO)

Health Plan

Healthcare

Healthcare Providers

Hospital

ICD-10

Keyboards

Korean Language

Leadership

Mandarin Chinese Language

Mathematics

Medical Records

Medicare

Multilingual

Onboarding

Operations Planning

Pharmacy

Physical Demands

Presentation/Verbal Skills

Primary Care

Problem Solving Skills

Quality Assurance

Quality Metrics

Quality of Care

Reporting Skills

Retail

Spanish Language

Standard Operating Procedures (SOP)

Statistics

Team Lead/Manager

Telemarketing

Time Management

Training/Teaching

Typing

Vietnamese Language

Work From Home

Writing Skills

equestftpin

UNKNOWN

Experian's people first, inclusive and purpose driven culture is multi award-winning; World's Best Workplaces 2025 (Fortune Global Top 25), Great Place To Work in 26 countries to name a few. You'll work with teams to resolve escalated issues, interpret consumer disputes, and deliver world-class service.

Company Description Experian is a global data and technology company, powering opportunities for people and businesses around the world. We operate across a range of markets, from financial services to healthcare, automotive, agribusiness, insurance, and many more. Experianinvests in people and new advanced technologies to unlock the power of data. We have an amazing team of 25,200 people in 32 countries. Job Description Are you a natural problem solver with experience helping people and experience navigating complex challenges? At Experian, we're looking for a Customer Care Specialist-Personal Visit Office who excels in an evolving environment and is ready to contribute You won't just answer questions, you'll be a trusted advisor, a compliance champion. You'll work with teams to resolve escalated issues, interpret consumer disputes, and deliver world-class service. You will work onsite and report to the Customer Care Manager Main Responsibilities <ul><li>Resolve complex and escalated customer inquiries with accuracy face-to-face. </li><li>Provide expert-level support for Experian's credit-related services and compliance processes. </li><li>Ensure all customer interactions meet regulatory and internal compliance standards. </li><li>Educate consumers on credit bureau procedures and advocate for credit improvement solutions. </li><li>Collaborate with team members to enhance service delivery and maintain high customer satisfaction. </li><li>Work onsite in the Santa Ana, CA office </li></ul>Qualifications What your background is:<ul><li>1+ years of experience in a phone-based contact center environment. </li><li>Experience interpreting and responding to customer requests and problem-solving skills. </li><li>High school diploma required. </li><li>Proficiency in customer service software, CRM systems, and basic computer applications. </li><li>Must pass background checks, credit screening, and drug testing </li><li>Office hours 8:30am-5:00pm PST </li><li>Bilingual English/Spanish ability encouraged </li></ul>Additional Information Our uniqueness is that we celebrate yours. Experian's people first, inclusive and purpose driven culture is multi award-winning; World's Best Workplaces 2025 (Fortune Global Top 25), Great Place To Work in 26 countries to name a few. Check out Experian Life on social or explore our Careers Site to understand why. Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. This position is also eligible for a variable pay opportunity and a comprehensive benefits package. Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity. Benefits<ul><li>Great compensation package and bonus plan. </li><li>Core benefits including medical, dental, vision, and matching 401K </li><li>Flexible work environment, ability to work remote, hybrid or in-office </li><li>Flexible time off including volunteer time off, vacation, sick and 12-paid holidays </li><li>Explore all our exciting benefits here: </li></ul>

Seeing the Collaboration in You 
Begin your new career here 
Experian is a global leader in providing information, analytical and marketing services to organizations and consumers to help them manage the risk and reward in making everyday commercial and financial decisions. 
Experian operates on a truly global scale, with offices in 44 countries. What’s more, because we have ambitious plans to extend our network, an opportunity may be closer than you think. 
We need people who are confident working across business lines, geographies and cultural boundaries. The challenge is certainly exhilarating and different office localities result in fascinating variations in local culture and methodologies. Come to Experian and you can experience a whole world of opportunities.

Hybrid Bilingual Jobs in Cucamonga, CA

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Hybrid Bilingual Jobs in Cucamonga, CA

Remote Outreach Concierge Navigator (Bilingual in Spanish) Alignment Healthcare USA, LLC

Customer Service Specialist-PVO Experian

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