Health Specialist Jobs

About The Position

Requirements

• At least 2 years of customer service, contact center, or member support experience; relevant college coursework or an Associate or Bachelor's degree may be considered in lieu of experience.
• High school diploma or GED.
• Demonstrated ability to use technology and follow detailed workflow instructions.
• Bilingual Mandarin Chinese and English.
• Proficiency navigating multiple systems simultaneously, including Microsoft Outlook, Word, Excel, CRM, and contact center solutions.
• Ability to maintain an on-camera presence for training and individual, team, and group meetings.
• A distraction-free workspace and ability to maintain strict confidentiality and comply with HIPAA regulations.
• Sufficient internet bandwidth and access to connect to company systems during scheduled shifts.
• Ability to care for and keep available technology equipment, including headsets and keyboard, to perform job duties without disrupting scheduled shifts.
• Clear, concise, warm verbal communication; ability to explain complex information simply and compassionately and accurately document interactions.
• Empathy, patience, and respect when working with older adults and individuals with disabilities.
• Minimum typing speed of 40 WPM.
• Comfort with continuous coaching, feedback, and performance improvement to meet KPIs for attendance, schedule adherence, and quality.
• Ability to manage high call volumes and emotionally sensitive interactions.
• Flexibility to work shifts to meet business needs.
• Ability to talk or hear regularly; stand, walk, sit, use hands and fingers, handle or feel objects, tools, or controls, and reach with hands and arms regularly; and frequently lift or move up to 10 pounds. Close vision and ability to adjust focus are also required.

Nice To Haves

• Knowledge of Medicare Advantage, Medi-Cal, or managed care plans.
• Strong problem-solving skills and a proactive, ownership-driven mindset.
• Organized, self-motivated, and comfortable working in a fast-paced environment.
• College degree, Associate's or Bachelor's; alternatively, 3 or more years of customer service work experience may be considered in lieu of a degree.

Responsibilities

• Build caring connections with members through empathy, patience, and respect.
• Own member interactions end-to-end, resolving inquiries during the initial contact where possible and following through on additional steps.
• Deliver exceptional service and reinforce trust, compassion, and first-call resolution.
• Respond accurately and clearly to inquiries about benefits, eligibility, services, policies, and procedures.
• Assist with provider network, claim, reimbursement, transportation, food, dental, and other support-service inquiries; identify solutions and next steps.
• Answer incoming contacts within established service levels and handle complex or sensitive situations professionally.
• Document member interactions, actions, and outcomes in real time.
• Address complaints, grievances, and disenrollment concerns by identifying root causes, offering solutions, and escalating when appropriate.
• Support outbound outreach and service programs intended to improve engagement, education, and member experience.
• Represent Alignment Health with integrity and a commitment to service excellence.
• Participate in coaching, feedback, and learning to strengthen service skills and member advocacy.