Sr. Specialist, Member Experience Team Lead

Accountabilities

• • Serve as the functional lead for Account Representatives, Senior Account Representatives, and Associate Account Representatives, providing daily guidance and support on priorities, service standards, and operational objectives.
  • Coordinate workload distribution, queue management, and resource allocation to optimize productivity, capacity, and member service levels.
  • Monitor workflow efficiency, turnaround times, team capacity, and operational bottlenecks, implementing solutions to improve performance.
  • Act as the primary escalation point for complex onboarding, eligibility, account maintenance, and member service issues.
  • Support departmental goals, projects, strategic initiatives, and accountability measures in partnership with senior leadership.
  • Support recruitment, candidate screening, interviewing, selection recommendations, onboarding, and training activities.
  • Provide ongoing coaching, mentoring, knowledge sharing, and performance guidance to help team members develop their capabilities.
  • Contribute to training curricula, competency models, skill assessments, and career development pathways.
  • Serve as a subject matter expert on member experience operations, onboarding, eligibility, account maintenance, service delivery, specialty pharmacy programs, pricing structures, portal functionality, and related workflows.
  • Act as an operational liaison across Sales, Contract Operations, Network, Product, IT, and other business partners.
  • Represent the Member Experience function in cross-functional projects, operational reviews, process improvement programs, and implementation initiatives.
  • Lead process mapping, workflow optimization, standardization, and future-state process design initiatives.
  • Identify opportunities to automate manual processes and partner with business and technology teams to test and implement automation solutions and system enhancements.
  • Support enhancements to Salesforce, Mercury, member portals, and other operational technologies.
  • Analyze recurring issues and root causes, implementing corrective actions to reduce rework, escalations, and operational friction.
  • Develop and maintain standard operating procedures, job aids, training materials, and process documentation.
  • Establish and maintain quality standards for onboarding, eligibility, account maintenance, and member service activities.
  • Monitor key operational metrics such as cycle times, escalation volumes, first-contact resolution, rework rates, productivity, and member satisfaction.
  • Develop reports, dashboards, and operational insights to support informed decision-making and recommend improvements based on performance trends.

  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.
  • Previous experience leading, coordinating, or overseeing small teams, ideally of approximately 10 or fewer employees.
  • Experience supporting recruitment, interviewing, onboarding, training, employee development, and performance guidance.
  • Demonstrated ability to provide day-to-day operational leadership and coach team members toward stronger performance.
  • Experience leading cross-functional projects, operational improvement initiatives, process redesign, or change management programs.
  • Experience identifying opportunities for workflow automation and implementing solutions that improve efficiency and scalability.
  • Strong understanding of operational workflows, service delivery, quality management, and member or customer experience principles.
  • Excellent problem-solving, analytical, organizational, and prioritization skills, with strong attention to detail.
  • Strong communication and interpersonal skills, with the ability to influence and collaborate effectively across teams.
  • Ability to lead and drive accountability without relying on direct reporting authority.
  • Proactive, adaptable, and continuous-improvement-oriented approach to operational challenges.
  • Ability to analyze performance data, identify trends and root causes, and translate insights into actionable improvements.
  • Familiarity with CRM, member service, portal, or operational technology platforms; experience with Salesforce or comparable systems is advantageous.

  Benefits

  • Annual salary range of $85,000–$100,000 USD.
  • Medical, dental, vision, and prescription coverage for employees and eligible family members.
  • Flexible Spending Account (FSA) and Health Savings Account (HSA) options, including company contributions.
  • Employee Assistance Program (EAP).
  • Telehealth access.
  • Fitness reimbursement.
  • Commuter benefit program.
  • Paid time off, paid holidays, birthday day off, and floating holidays.
  • Paid parental leave.
  • 401(k) retirement plan with company matching.
  • Employee Stock Purchase Plan (ESPP).
  • Life insurance and short-term and long-term disability coverage.
  • Access to financial and legal advisory resources.
  • Employee perks and benefit discounts.
  • Tuition reimbursement and e-learning opportunities.
  • Ongoing team training and professional development programs.
  • Paid volunteer time off and donation matching.
  • Flexible work arrangements, including remote, onsite, or hybrid options as determined by business and management needs.
  • Opportunity to contribute to meaningful healthcare operations and member experience initiatives while supporting continuous innovation and process improvement.