Member Services Director

We have an opportunity to join the Alliance as the Member Services Director overseeing the Member Services Department. There is one position which can be filled in any of our 3 offices (Merced, Salinas or Scotts Valley).

The Alliance is a public, not-for-profit health plan that is responsive and accountable to the members we serve. Our successes in expanding health care access, quality and developing new programs are attributed to the level of commitment and professionalism of those who work here. If you are interested in a stimulating and rewarding work environment where you can positively impact the lives of others, we invite you to apply, check out our current openings below. We are values-based and believe that our culture and workplace should be respectful, diverse, professional and fun.

Reporting to the Chief Operating Officer, you will provide strategic management oversight in implementing, directing and monitoring the Alliance’s Member Services functions. You will direct the Member Services Department, act as a subject matter expert, and provide executive level advice and guidance on member services issues and overall business operations. You will also direct, manage and supervise Member Services Department staff.

The Member Services team is a dedicated, mission-driven group of individuals who have a passion for the work we do. We empower members to understand Alliance services and provide resources that meet medical, cultural and social needs to improve member health and well-being. We take great pride in the impact our work has on our members, providers and community.

• Expertise leading the member services function within community-based health plan environments
• Strategic vision, with a passion for developing and implementing new programs
• Strength in cultural competency with the ability to connect with the Alliance’s diverse member population
• Customer focus, with the ability to build and nurture relationships that engage our internal and external partners including our employees and community partners
• Commitment to team development ensuring a professional environment that is inspired, supported, professional and fun
• Talent in leading teams in an ever evolving, fast-paced environment

To read the full position description and list of requirements, please visit our website.

Knowledge of:
o Member services function in a healthcare environment
o Legal requirements related to privacy and healthcare operations, including the Health Insurance Portability and Accountability Act (HIPAA)
o Medi-Cal, Medicaid, Medicare, government programs, and related regulations
o Principles and practices of providing healthcare services to economically vulnerable populations
o Principles and practices of managed care member grievance resolution

Ability to:
o Direct, manage, supervise, mentor, train and evaluate the work of staff
o Develop, plan, organize and direct programs and activities that are complex in nature and regional in scope
o Provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues
o Demonstrate strong analytical skills, accurately collect, manage and analyze data, identify issues, offer recommendations and potential consequences, and mitigate risk
o Review and assess overall department function, core work, goals and structure, develop and implement short- and long-term planning to achieve strategic plans, and complete an annual department assessment
o Ability to foster effective working relationships, influence others, and build consensus with individuals at all levels in the organization

Education and Experience:
o Master’s degree in Public Health, Business, Health Administration or a related field
o Eight years (or a Bachelor’s and ten years) of experience within a health care organization, which included management experience with the Medi-Cal program and member services, or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifying

• While this position is connected to one of our Alliance offices, we are in a fully remote work environment right now due to COVID-19. The interview and on-boarding process will be completed remotely
• When operations resume in the office, the expectation for this position is that it will be in the office, at least a few days a week. For this reason, we are only considering candidates who are able to work in-person at one of our Alliance offices in the future

Position Description »