Manager, Member Experience

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee daily operations to ensure an efficient workflow and optimal effectiveness.

• Supervise the management of member cases, guaranteeing timely and satisfactory resolutions to all issues.

• Monitor case workflows and address complex or escalated issues to uphold high service standards.

• Track call volume and performance metrics, making necessary adjustments to meet and exceed service objectives.

• Ensure compliance with organizational policies, procedures, and applicable healthcare regulations.

• Conduct regular performance evaluations, provide constructive feedback, and implement training programs to fill skill gaps.

• Handle the resolution of intricate member inquiries and issues, ensuring prompt and effective solutions.

• Develop and enhance best practices and procedures to improve efficiency, effectiveness, and member satisfaction.

• Deeply engage with VIVIO’s processes and procedures to understand, execute, and continuously improve operations.

• Offer guidance and support to team members handling challenging cases.

• Perform root cause analysis for significant case escalations and drive continuous improvement efforts.

• Lead, motivate, and develop the team to accomplish both individual and collective goals.

• Foster a positive and collaborative team atmosphere, promoting open communication and professional development.

• Monitor key performance indicators, conduct regular audits, and prepare routine reports on team performance.

• Utilize data-driven insights to make informed decisions and promote ongoing enhancement.

• Facilitate clear and effective communication within the team, ensuring alignment with objectives and expectations.

• Collaborate with healthcare providers, pharmacies, and other departments to efficiently address member inquiries and concerns.

• Share updates, discuss challenges, and celebrate team achievements.

• Provide tailored support to team members, encouraging open dialogue and addressing emerging issues.

• Work alongside cross-functional teams to achieve shared goals, promote communication, and drive project success.

⛳️ Requirements

• Proven experience in successfully leading and developing teams, with outstanding interpersonal and communication skills.

• A minimum of 5 years of experience in the healthcare sector, focusing on care coordination, member advocacy, or related fields.

• At least 5 years of leadership experience in member service and case management within a healthcare environment; remote call center experience is highly preferred.

• An associate’s degree or higher in business administration, management, or a related discipline, or equivalent experience is mandatory.

• Willingness to travel occasionally for business, including meetings, site training, or VIVIO-related events.

• Demonstrated ability to succeed in a high-volume, fast-paced, and dynamic team environment.

• Previous experience in a call center leadership position is essential.

• Prior experience with PBM is a plus.

• Strong analytical and problem-solving skills, with a focus on resolving complex member inquiries and optimizing processes.

• Proficiency in Microsoft Office Applications (Word, PowerPoint, Excel, Outlook, Teams, etc.).

• Excellent organizational skills with the capability to manage multiple tasks, prioritize effectively, and maintain attention to detail.

• An active problem solver with a proactive “figure it out” mindset.

• A clear, effective, and proactive communicator.

🏝️ Benefits

• Bonus Eligible

• Health benefits including Medical, Pharmacy, Dental, Vision, and Life insurance.

• Stock Options

• 401K match

• PTO

• Opportunity to work for a growing and innovative company.

• Dynamic and collaborative work environment.

• The chance to make a real impact with a Public Benefit Corporation.