Member Care Team Manager

About the role

The Member Care Team sits at the intersection of Member Experience and Clinical Operations, supported by internal Member Care Coordinators and a third party Business Process Outsourcing vendor. The role of the Member Care Team Manager is to drive consistent and high quality member experiences by leading a team of Member Care Coordinators. This role is filled with leadership responsibilities requiring excellence in high output operations coupled with superb member touch, ensuring that all of our members receive timely and effective resolutions to their issues. This includes enrollment, onboarding, retention, and dis-enrollment phases of the member journey, as well as supporting clinical and pharmacy operations.

Key responsibilities

• Lead a team of Member Care Coordinators supporting members across multiple channels (currently including in-app messaging and phone)
• Partner with the Member Care Team Operations Manager to ensure alignment on processes, policies, and procedures
• Function as a bidirectional communication bridge between the broader business and the Member Care Team
• Analyze member feedback and escalation reasons to identify trends and areas for improvement
• Manage a team of specialists, providing guidance and support to ensure they are meeting performance targets and delivering excellent member experiences
• Develop and implement processes and protocols to ensure that all member concerns and experiences are handled expeditiously and efficiently
• Collaborate with cross-functional teams to identify and resolve systemic issues that lead to member complaints and escalations
• Collaborate with clinical leadership to provide Medical Assistant level support for pharmacy and clinical issues
• Develop and deliver training to enhance the skills and knowledge of the Member Care Team
• Monitor and report on internal KPIs and SLAs
• Understand our goals, utilize analytic solutions, and create positive change for members and the Member Care Team
• Be the main point of contact for high-profile relationships with focus on ways we can be proactive vs. reactive.
• Lead Quality Assurance (QA) and Audit Cycles - design and execute quality audits across all channels and tasks performed by the internal Member Care Team to ensure compliance and identify coaching gaps
• Develop and execute a roadmap for process improvement, utilizing insights from quality audits, VOC, and KPI reporting to drive measurable efficiencies across internal teams and collaborate with the Member Care Team Operations Manager on vendor improvements that align and compliment internal processes

Qualifications

• 3+ years of experience in customer facing and/or operational roles required
• 1+ years of people management experience
• Relevant experience in a work from home environment
• Healthcare industry experience required; bonus points if you’re knowledgeable about the insurance industry and have experience working on insurance claims processes
• Are patient, personable, and kind -- in writing, in person, on the phone, or on video
• Creative problem-solving skills that can be leveraged to empower others
• Experience in hospitality, member services, or customer support, ideally in a high-growth organization or startup environment
• Experience designing, implementing, and training teams on executing processes at scale
• Experience effectively managing support teams and driving outcomes at scale
• Ability to quickly pivot from creating process and efficiency at scale to then going deep on a particular member situation in order to solve a nuanced challenge
• Ability to learn quickly and be comfortable using a variety of applications and software, including practice management systems, electronic health records, and related software; bonus points for experience with Google Sheets and Slack
• Ability to be flexible and embrace change while remaining highly organized
• Proficiency with Looker, Google Sheets, or other BI tools to analyze performance data and translate trends into actionable business insights
• Proven ability to synthesize complex operational failures (e.g., system bugs, PBM issues) into clear, concise, and actionable updates for the Senior Leadership Team

Benefits

• Enjoy a generous paid time off policy, including multiple paid company holidays, wellness days, and floating holidays to support your work-life blend.
• Medical, dental, and vision benefit options to keep you and your family healthy.
• Calibrate-funded disability and basic life insurance, ensuring peace of mind during unforeseen events.
• Access to several wellness programs, including a complimentary Headspace membership, and therapy on your schedule with Headspace Care.
• Employee Assistance Program through Principal to receive counseling on a wide range of topics.
• Remote-first ways of working, with the flexibility to work from any state.
• Competitive paid parental leave program to support new parents.

Pay

$60,000 - $65,000 annual salary

Schedule

Remote (United States)