VP, Member Experience

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. Position Summary Responsible for managing internal teams and outsourced partners including inbound and outbound call, Appeals and Grievances and BPO vendor oversight. Create and implement member engagement strategies (Proactive and reactive) that will drive retention and increase member satisfaction. Responsibilities Design and deliver key initiatives to continuously reinforce and strengthen Alignments "Senior First" mission that translate to strong member engagement, overall satisfaction and retention. Execute Alignments Care Navigation Strategy & technology deployment. Test and evaluate member engagement approaches to ensure Alignment drives broad and active engagement across various programs and key initiatives. Collaborate closely with key internal partners to ensure that members remain at the center of everything we do. Assist the COO in the implementation of strategic & business plans including planning and budgeting activities. Examine, interpret, and report results of analytics and outcome-based measures. Responsible for refining and executing Care Navigation strategy including customer developed CRM, telecommunication platform and analytics to deliver member insights and actions. Leads teams focused on member experience across the Enterprise. Strategizes, executes, and manages in-house and outsourced operations to ensure optimal efficiency, data integrity, and service. Leads Appeals and Grievances program with a focus on continuous quality improvement and effectiveness. Analyzes results and leads Quality initiatives to reduce the number of overturned appeals and grievances. Seeks ways to innovate workflow process improvements and automation of the data environment while maximizing system investments and integration. Ensures strong customer service orientation of staff and ensures market needs are meeting stringent quality standards while ensuring efficiency and effectiveness of departments. Develops & implements plans to resolve and remediate quality or service issues related. Ensure a collaborative environment within the department and organization to facilitate solutions and optimal performance. Accountable for the identification and implementation of strategies to promote member engagement and retention. Establish and manage processes to regularly report standard metrics related to member experience. Requires some travel. Performs other related duties as assigned. Supervisory Responsibilities Oversees assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees. Ensure the team is structured appropriately to meet key priorities; assesses skill level to ensure team members are in the right roles, supporting skill development as needed. Minimum Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimum 10 years of consumer / member experience in a healthcare environment. 5-7 years of Call Center experience. Medicare Appeals and Grievances experience preferred. Education / Licensure Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and / or training, or equivalent combination of education and experience. Master's Degree (MA) preferred. Other Demonstrated track record of generating results and having an impact on organizations. Proven success streamlining operations and experience running efficient operations is a plus. Strategic and forward-thinking mindset. Strong leadership skills with the ability to develop teams. Innovative in problem solving, planning, and strategizing. Articulate & persuasive in preparing / presenting business-case for change-management, including at both detailed and executive level where required. Effective interpersonal skills to consistently demonstrate expertise, business knowledge and team cohesiveness. Excellent communication skills, especially in one-on-one and small-large group settings is essential. Work Environment The 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 job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 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. 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 $149,882.00 - $224,823.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Equal Opportunity / Affiant Statement Alignment Health is an Equal Opportunity / Affiant 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. EEO Statement Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affiant Action. We are looking for diversity in qualified candidates for employment : Minority / Female / Disable / Protected Veteran. Disclaimer PLEASE BEWARE OF RECIPIENT PHISHING SCAMS Affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. If you feel 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 . #J-18808-Ljbffr