Manager, Member Experience

Operational Leadership:

• Manage daily operations, ensuring smooth workflow and maximum efficiency. • Supervise the management of member cases, ensuring all issues are resolved in a timely and satisfactory manner. • Monitor case workflows and resolve complex or escalated issues to maintain high service standards. • Monitor call volume and performance metrics, making necessary adjustments to meet and exceed service goals. • Ensure adherence to organizational policies, procedures, and relevant healthcare regulations. • Conduct regular performance reviews, provide constructive feedback, and implement training programs to address skill gaps.

Process Improvement and Problem-Solving:

• Manage the resolution of complex member inquiries and issues, ensuring prompt and effective solutions. • Implement and refine best practices and procedures to enhance efficiency, effectiveness, and member satisfaction. • Immerse yourself in VIVIO’s processes and procedures, first for understanding and execution, then for continuous enhancement. • Provide guidance and support to team members dealing with challenging cases, leveraging your expertise. • Conduct root cause analysis for significant case escalations and drive continuous improvement initiatives.

Team Management and Development:

• Lead, motivate, and develop the team to achieve individual and team goals. • Conduct regular performance reviews, provide constructive feedback, and implement training programs to address skill gaps. • Promote a positive and collaborative team environment, encouraging open communication and professional growth.

Performance Monitoring:

• Track key performance indicators (KPIs), conduct regular audits and prepare regular reports on team performance. • Use data-driven insights to make informed decisions and drive continuous improvement.

Communication and Collaboration:

• Facilitate clear, effective communication within the team, ensuring alignment with goals and expectations. • Collaborate with healthcare providers, pharmacies, and other departments to address member inquiries and concerns efficiently. • Share updates, discuss challenges, and celebrate team successes to foster a cohesive and motivated team environment. • Provide individualized support to team members, promoting open dialogue and addressing emerging issues. • Work with cross-functional teams to achieve common goals, facilitate communication, and drive project success by leveraging diverse perspectives and expertise. • Strong track record of successfully leading and developing teams, with excellent interpersonal and communication skills. • At least 5 years of experience in the healthcare industry, with a focus on care coordination, member advocacy, or related roles. • Minimum of 5 years of member service leadership and case management experience, within a healthcare setting; remote call center experience highly preferred. • Education: An associate’s degree or higher in business administration, management, or a related field or equivalent experience is required. • Travel: Must be willing to travel occasionally for business purposes, including meetings, site training, or VIVIO-related events • Proven ability to thrive in a high-volume, fast-paced, and evolving team environment. Prior experience in a call center leadership role. • Prior PBM experience nice to have • Strong analytical and problem-solving abilities, focusing on resolving complex member inquiries and optimizing processes. • Proficiency in Microsoft Office Applications (Word, PowerPoint, Excel, Outlook, Teams, etc.). • Exceptional organizational skills with the ability to manage multiple tasks, prioritize effectively, and maintain attention to detail. • An active problem solver with a “figure it out” mindset. • A clear, effective, and proactive communicator. • The anticipated salary range for this position is $73,000-$85,000 per year. The actual salary offered will be determined by a variety of factors, including the candidate’s qualifications, experience, and the position's geographic location. • Bonus Eligible • Health benefits including Medical, Pharmacy, Dental, Vision, 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.