Supervisor, Customer Reimbursement and Digital

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

📋 Description

• Lead and mentor a team of Customer Experience Resolution and Reimbursement Specialists

• Assist with digital member communications and the processing of reimbursements

• Establish performance benchmarks for quality, turnaround time, productivity, compliance, and member satisfaction

• Engage in coaching sessions, case evaluations, and quality assessments

• Facilitate onboarding, training, and ongoing skill enhancement

• Optimize workflows, minimize processing delays, and improve member experience

• Raise regulatory or procedural issues and collaborate with leadership for enhancements

• Track operational metrics, trends, and member satisfaction levels

• Create action plans to boost productivity, quality, and service results

• Assist with precise and timely operational reporting

• Ensure prompt, clear, professional, and compliant responses to member inquiries

• Promote digital adoption and effective use of service channels

• Guarantee accurate CRM documentation in line with organizational, CMS, and regulatory guidelines

• Collaborate with Operations, Technology, Compliance, and other internal teams

• Engage in cross-functional workflows and continuous improvement initiatives

• Oversee Specialists and aid in hiring, onboarding, coaching, performance management, recognition, and corrective actions

• Ensure adherence to Alignment policies, CMS regulations, and relevant laws

• Report directly to the Director of Customer Resolution

⛳️ Requirements

• Minimum of 5 years experience in healthcare contact centers, member services, or resolution roles within a managed care setting

• Knowledge of grievances, appeals, Direct Member Reimbursements, and CMS-regulated environments

• High School Diploma or GED required

• An equivalent combination of education and experience may be accepted

• Familiarity with Medicare Managed Care (Parts C and D) and CMS compliance standards

• Strong understanding of case management workflows and turnaround time optimization

• Capability to coach for empathy, clarity, ownership, and effective resolution

• Ability to analyze trends and root causes through performance data

• Exceptional written and verbal communication skills, especially in digital formats

• Strong organizational abilities with the capacity to handle competing priorities

• Ability to balance empathy with operational efficiency in a fast-paced environment

• Reliable internet access

• Capability to manage multiple projects simultaneously

• Strict compliance with HIPAA and confidentiality protocols

• Bilingual (English/Spanish) preferred

• Preferred 2+ years of supervisory or team leadership experience

• Experience with Medicare Advantage populations is highly desirable

🏝️ Benefits

• Opportunities for growth and innovation

• Professional development resources

• Reasonable accommodations for individuals with disabilities

• Commitment to equal employment opportunity