Digital Reimbursement & Member Care Lead

Alignment Healthcare USA, LLC

Orange (CA)

Hybrid

USD 59,000 - 88,000

Full time

14 days+

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Job summary

Alignment Health seeks a seasoned supervisor to lead the Digital Member Communications and Reimbursement team in a hybrid U.S. setting.

You will coach staff, manage performance metrics, and ensure regulatory compliance across CMS environments while fostering a caring, service-oriented culture aligned with Alignment Health values. The role emphasizes coaching for empathy, timely resolution, and data-driven improvements.

Qualifications

5+ years of healthcare contact center, member services, or resolution experience in a managed care organization.
Familiarity with grievances, appeals, Direct Member Reimbursements, and CMS environments.
Bachelor’s degree preferred; equivalent experience considered.
Strong coaching, empathy, and ability to coach for resolution.
Excellent written and verbal communication in digital channels.

Responsibilities

Direct supervision of Digital member communications and reimbursement processing specialists.
Set performance expectations for quality, turnaround time, productivity, and compliance.
Coach, train, and develop staff; conduct regular audits and reviews.
Collaborate with Operations, Technology, Compliance and other teams to improve workflows.
Ensure documentation accuracy in CRM systems and regulatory readiness.