Regional Concierge Navigator (Bilingual in Spanish)
El Paso, Texas, United States · Remote OK
$45k–$67k/yr
Entry level$696M raised
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Regional Concierge Navigator (Bilingual in Spanish)
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$45k–$67k/yr
Full-time
high school
Posted 49d ago
~40 hrs/week
Remote in El Paso, Texas, United States
Responsibilities
The Regional Concierge Navigator provides outreach and support to members to help them navigate healthcare benefits and access necessary care. They act as a liaison between members, providers, and health plan operations to ensure coordinated care and resolve member issues.
Requirements
Requires a high school diploma or GED and at least one year of customer service experience. Candidates must have knowledge of ICD-10 and CPT codes and the ability to navigate Medicare Advantage or HMO systems.
Full job description
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:
Knowledge of ICD-10 and CPT codes.
Keyboard typing 40+ words per minute.
Ability to help members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations.
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
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. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
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.
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Preferred: Bilingual English/Spanish or English/Vietnamese or English/Mandarin. Fluency in written and verbal Spanish, Korean, or Vietnamese, a plus.
Licensure:
Required: None
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 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 [email protected].
Alignment Health is redefining the business of health care by shifting the focus from payments to people. We’ve created a new model for health care delivery that cuts costs and improves lives by unraveling the inefficiencies of the current system to drive patients, providers and payers toward a common goal of wellness. Harnessing best practices from Medicare Advantage, our innovative data-management technology allows us to commit to caring for seniors and those who need it most: the chronically ill and frail. Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers health plan options through Alignment Health Plan, and also partners with select health plans to help deliver better benefits at lower costs. For more information, please visit www.alignmenthealthcare.com.
Offices: 1100 W. Town and Country Road, Suite 1600, Orange, CA 92868, US
Medicare AdvantageAccountable care organizationPopulation health managementand MedicareHospitalHealth CareMedical DeviceWellnessAutomotiveMedical
How many Social Services jobs are open in El Paso, TX right now?
There are currently 260 open social services positions in El Paso, TX listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Social Services roles in El Paso, TX?
Companies currently hiring include Bienvivir All-Inclusive Senior Health, Aiken Regional Medical Centers, IDEA Public Schools, Texas Health and Human Services, ALIVIANE, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Social Services jobs in El Paso, TX?
Yes — 27 of the 260 open social services positions offer remote or hybrid work (7 remote, 20 hybrid).
How do I apply for Social Services jobs in El Paso, TX?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.