Senior Specialist, Team Lead Member Experience

Accountabilities:

• • Serve as the functional lead for Account Representatives and related member experience roles, providing day-to-day guidance, coordinating priorities, supporting workload distribution, and helping ensure consistent execution of service and operational objectives.
  • Monitor team capacity, queue management, workflow efficiency, turnaround times, and service levels, identifying bottlenecks and implementing practical solutions to improve productivity and member outcomes.
  • Act as the primary escalation resource for complex onboarding, eligibility, account maintenance, and member service issues, providing subject matter expertise and helping resolve situations that require deeper operational knowledge.
  • Support recruitment, interviewing, onboarding, training, coaching, mentoring, and ongoing development activities, while helping identify performance concerns, knowledge gaps, and opportunities for individual and team improvement.
  • Lead knowledge-sharing initiatives and promote consistent adoption of best practices, training standards, competency expectations, and career development approaches across the team.
  • Serve as a subject matter expert across member experience operations, including onboarding, eligibility, account maintenance, service delivery processes, specialty pharmacy programs, pricing structures, portal functionality, and related workflows.
  • Partner with Sales, Contract Operations, Network, Product, IT, and other stakeholders on cross-functional initiatives, operational reviews, new product or service implementations, and member experience enhancements.
  • Lead process mapping, workflow optimization, standardization, and operational improvement initiatives, identifying opportunities to reduce manual effort, improve scalability, and eliminate operational friction.
  • Partner with business and technology teams to define, test, and implement automation solutions and system enhancements across Salesforce, Mercury, member portals, and other operational technologies.
  • Analyze recurring issues and operational trends, conduct root cause analysis, and implement corrective actions that reduce rework, escalations, delays, and inconsistent service experiences.
  • Develop and maintain standard operating procedures, job aids, training materials, process documentation, and future-state workflows that support operational consistency and scalability.
  • Establish and maintain quality standards while monitoring metrics such as cycle times, escalation volumes, first-contact resolution, rework, productivity, and member satisfaction indicators.
  • Develop reports, dashboards, and operational insights, using performance data to identify risks, recommend corrective actions, and support departmental business reviews and strategic decision-making.

  Requirements:

  • Bachelor’s degree or an equivalent combination of education and relevant professional experience.
  • At least 5 years of experience in member services, account management, customer success, healthcare operations, specialty pharmacy, or a related field involving complex customer or member-facing processes.
  • Previous experience leading, coordinating, or overseeing small teams, ideally involving approximately 10 or fewer employees, with the ability to provide structure and direction without relying on formal direct-report authority.
  • Experience supporting recruitment, candidate interviews, onboarding, training, employee development, and ongoing knowledge-sharing initiatives.
  • Demonstrated experience providing coaching, performance guidance, operational support, and day-to-day leadership within a service-oriented environment.
  • Experience leading cross-functional projects, operational improvement programs, workflow redesign, or change management initiatives involving multiple business or technology stakeholders.
  • Proven ability to identify opportunities for workflow automation, process standardization, and operational efficiency, and to help translate those opportunities into practical technology or process solutions.
  • Strong analytical skills with the ability to interpret operational metrics, identify trends and root causes, develop actionable recommendations, and communicate findings to stakeholders.
  • Strong organizational and prioritization skills, with the ability to coordinate competing workflows, manage escalations, and maintain attention to service quality in a fast-paced operational environment.
  • Excellent communication and interpersonal skills, with the ability to coach colleagues, collaborate across functions, manage complex issues, and build trust with internal and external stakeholders.
  • A continuous-improvement mindset, with the initiative to identify operational friction, challenge inefficient processes, and contribute to scalable solutions.

  Benefits:

  • $85,000–$100,000 annual salary, with placement within the range based on factors such as education, qualifications, certifications, experience, skills, geographic location, and organizational needs.
  • Medical, dental, vision, and prescription coverage with options for employees and families.
  • Flexible Spending Account and Health Savings Account options, including employer contributions.
  • Employee Assistance Program, fitness reimbursement, and access to wellness resources.
  • Short-term and long-term disability coverage and life insurance.
  • 401(k) retirement plan with company matching.
  • Employee Stock Purchase Plan (ESPP).
  • Paid time off, paid holidays, floating holidays, and a birthday day off.
  • Paid parental leave and additional time-off flexibility.
  • Commuter benefit programs and access to financial and legal advisory resources.
  • Tuition reimbursement, e-learning programs, and ongoing team training.
  • Paid volunteer time and donation matching programs.
  • Perks and benefits discounts, along with opportunities to contribute to meaningful healthcare-related initiatives.
  • Flexible onsite, remote, or hybrid work arrangements as directed by the manager.