Client Escalations Specialist

Responsibilities

• Serve as the primary point of contact for high-priority sales and client escalations, ensuring timely, high-quality resolution in line with SLAs
• Partner closely with Client Success team to drive confidence and enable account growth through responsive, solution-oriented escalation management
• Cross-coordinate cross-functional efforts across Operations, Pharmacy Support, and other internal teams to resolve complex prescription and access issues
• Identify root causes of recurring escalations and partner with internal teams to drive process improvements and reduce future volume of escalations
• Maintain clear and proactive communication with stakeholders, including internal teams, prescribers, and payer/pharmacy partners as needed
• Support the evolution of escalation workflows, documentation, and tooling to improve efficiency and scalability as the business grows
• Contribute to staffing and operational planning by identifying trends in escalation volume, particularly during key growth moments (e.g., new client launches, salesforce expansion)
• Leverage expertise in pharmacy processing to accurately diagnose claim rejections (e.g., plan benefit exclusions, prior authorization requirements, or network restrictions) and identify whether the resolution requires intervention from the insurance payer, provider office, or partner pharmacy

Qualifications

• Bachelor’s degree in Business, Healthcare Administration, or a related field (or equivalent experience)
• 4–7+ years of experience in client support, escalation management, operations, or a similar function, preferably in healthcare or health-tech
• Strong problem-solving skills with the ability to navigate ambiguity and manage complex, high-stakes situations
• Experience working cross-functionally with Sales, Operations, and external stakeholders in a fast-paced environment
• Excellent communication skills, with the ability to manage sensitive situations and maintain trust with internal and external partners
• Proven ability to prioritize effectively and manage multiple escalations simultaneously while meeting SLAs
• Data-driven mindset with experience identifying trends and driving process improvements