Teams at Alignment Healthcare

Build and operate a cloud-based data platform, including complex ETL pipelines, data warehouse integrations, and large-scale data processing systems. Gather business requirements, develop datasets, combine heterogeneous data sources, resolve data quality issues, and support ad hoc data access. The role also involves data modeling for AI and machine learning, migrating on-premises systems to cloud and big data architectures, and potentially mentoring engineers and providing technical leadership.

Oversee Medicare Advantage enrollment operations, including processing, reconciliation, CMS reporting, discrepancy resolution, eligibility verification, and regulatory compliance. Review MARx files and transaction reports, manage D-SNP and C-SNP reconciliations, resolve enrollment inquiries, maintain accurate records, and support internal teams. Serve as a subject matter expert for enrollment systems and CMS requirements while mentoring peers and escalating complex issues.

Generates new health plan enrollments and retains existing members through inbound and outbound telephone interactions. Handles inquiries from prospective members, providers, and community partners; directs prospects to field sales when appropriate; conducts enrollment and disenrollment campaigns; submits activity reports; follows CMS, federal, state, and company marketing guidelines; supports competitor analysis and Sales and Marketing projects.