Alignment Healthcare
Remote Quality Retention Specialist (
Davidson , NC · Junior
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About the role
- 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.
- We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.
- Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them.
Responsibilities
- Provides outbound support for PCP/IPA terminations.
- Supports other projects and duties as assigned.
- The Quality Retention Specialist supports our members in their disenrollment requests and related quality assurance.
Requirements
- 1+ year experience with Medi-Cal, Commercial, and Medicare Managed Care Plans and/or Sales, Customer Service, or Membership and Eligibility.
- Ability to communicate positively, professionally and effectively with others
- Mathematical Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's.
- Reasoning Skills: Ability to apply common sense understanding to carry out detailed, but un-involved written or oral instructions.
- Shares best practices and participating in team meetings or training as required.
- Responsible for real-time documentation and timely wrap-up to support outcomes reporting in all systems/applications as required
- 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.
Nice to have
- High School Diploma or GED.
- Bilingual in one of the following Spanish, Vietnamese, Mandarin, Cantonese, or Korean
- Preferred: Bilingual in one of the following Spanish, Vietnamese, Mandarin, Cantonese, or Korean
Skills
- Solid knowledge and understanding of the Medicare Managed Care Manual Chapter 2
- Medicare Advantage Enrollment and Disenrollment and Medicare Communications and Marketing Guidelines.
- Ability to troubleshoot/problem solve.
- Ability to write routine reports and correspondence.
- Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's.
- Ability to apply common sense understanding to carry out detailed, but un-involved written or oral instructions.
- Ability to deal with problems involving a few concrete variables in standardized situations.
- Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
- Required:
- Language
- Mathematical
- Reasoning
Compensation
- $38,569.00 - $57,853.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Benefits
- In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community.
- 1+ year of healthcare experience.
- Specific vision abilities required by this job include close vision and the ability to adjust focus.
Company info
- It takes an entire team of passionate and caring people, united in our mission to put the senior first.
- Ability to speak effectively before groups of customers or employees of the organization. - Mathematical Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's.
- 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.
This listing is sourced directly from Alignment Healthcare's careers page and normalized into a canonical job model.