Posted 20 Nov 2023, 7:35 pm

Senior Member Services Representative at Central California Alliance for Health


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 Monday through Friday in the Mariposa County offices.



  • 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
  • Assists with special projects, as assigned



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

  • Knowledge of:
    • Bilingual (English/Spanish or English/Hmong) preferred for Mariposa County only
    • Principles and practices of customer service
    • Managed health care in a health plan environment
    • Eligibility processes and guidelines associated with one or more of the following: the Medi-Cal program, Social Security programs, foster care, adoption assistance, and/or other public assistance programs
    • Conflict resolution techniques
    • Windows-based PC systems and Microsoft Word, Outlook and Excel, and database systems
  • 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
    • Translate healthcare-related terminology and complex processes into simple language and step-by-step instructions when communicating with members and providers
    • Gather and evaluate information, ask appropriate questions and utilize active listening and problem-solving skills
  • Education and Experience:
    • High school diploma or equivalent 
    • 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



  • While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
  • Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
  • Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.



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Source: Remote Ok