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Senior Member Services Representative

Central California Alliance for Health
paid time off, paid holidays, retirement plan
United States, California, Mariposa
Feb 27, 2025
Senior Member Services Representative

Location: Mariposa County, California

We have an opportunity to join the Alliance as a Senior Member Services Representative in the Member Services Call Center Department.

There is one position available in our Mariposa service area and will be on-site three days per week in the Mariposa County offices.



WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Member Services Supervisor, this position:



  • Responds to complex member issues and acts as a technical resource for Member Services Representatives
  • Acts as a frontline customer service representative within the Member Services Department, providing assistance to members and providers primarily by phone
  • Participating in departmental work groups and special projects



ABOUT THE TEAM

Our teams work together to empower members to understand Alliance services and provide resources that meet medical, cultural and social needs to improve member health and well-being. We answer calls from Alliance members, which may include general questions about the plan, require help finding a primary care provider or bring up an issue that needs resolution.

THE IDEAL CANDIDATE



  • Has a passion for providing high-quality customer service to diverse communities while also contributing to a positive and supportive work environment.
  • Has strong interpersonal skills to resolve member issues and provide resources as needed.
  • Is familiar with Medicare, Medi-Cal, managed health care, and social services.
  • Has experience working in a call center or member services setting.
  • Is adaptable and comfortable working in the office or remotely multiple days a week.
  • Has the ability to work in a team-orientated environment and interact with others showing respect and understanding.



WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.



  • Knowledge of:


    • Principles and best practices of customer service
    • Eligibility processes and guidelines associated with one or more of the following: Medi-Cal program, Social Security programs, foster care, adoption assistance, and/or other public assistance programs


  • Ability to:

    • Answer telephone calls promptly and minimize delays that may lead to missed calls
    • Act as a technical resource for Member Services Representatives
    • De-escalate complex situations, including complaints
    • Understand and communicate the complex operations and processes of the Alliance, particularly those related to Member Services and Care Management, to members and providers


  • Education and Experience:

    • High school diploma or equivalent
    • A minimum of four years of customer service experience in member services, health care, public assistance, human services or in a customer service or call center environment which included a minimum of two years of experience in a health care setting which involved assisting members and/or providers with eligibility processes and guidelines (an Associate's degree may substitute for one year of the general customer service experience); or an equivalent combination of education and experience may be qualifying





OTHER INFORMATION



  • We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
  • While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
  • In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.



The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Zone 2 (Mariposa and Merced)
$22.40 - $35.84 USD
OUR BENEFITS

Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.



  • Medical, Dental and Vision Plans
  • Ample Paid Time Off
  • 12 Paid Holidays per year
  • 401(a) Retirement Plan
  • 457 Deferred Compensation Plan
  • Robust Health and Wellness Program
  • Onsite EV Charging Stations


ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

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