Who we're looking for: The Senior Specialist, Member Experience Team Lead serves as the functional lead for the Member Experience team and provides day-to-day leadership, operational oversight, coaching, and subject matter expertise for Account Representatives, Senior Account Representatives, and Associate Account Representatives. Reporting to the Sr. Manager, Member Experience, this role supports team performance, onboarding, quality standards, process improvement, automation initiatives, and cross-functional operational execution.
While the position does not have direct reports, it serves as the primary resource for team guidance, escalation management, training, workflow coordination, and continuous improvement efforts. The Team Lead plays a critical role in ensuring operational excellence, service consistency, and a high-quality member experience across all Member Experience functions.
What You'll Be Doing: Team Leadership & Operational Oversight- Serve as the functional lead for Account Representatives, Senior Account Representatives, and Associate Account Representatives.
- Provide day-to-day leadership, guidance, and support to ensure consistent execution of team priorities, service standards, and operational objectives.
- Coordinate workload distribution, queue management, and resource allocation to optimize productivity and member service levels.
- Monitor team capacity, workflow efficiency, and turnaround times; identify bottlenecks and implement solutions to improve performance.
- Serve as the primary escalation point for complex onboarding, eligibility, account maintenance, and member service issues.
- Support the Sr. Manager, Member Experience in executing departmental goals, projects, and operational initiatives.
- Assist in establishing team priorities, monitoring progress, and driving accountability for key deliverables.
Team Development, Onboarding & Performance Support- Support recruitment activities, including candidate screening, interviewing, and selection recommendations.
- Lead onboarding and training programs to ensure successful integration of new team members.
- Provide ongoing coaching, mentoring, and development support to improve individual and team performance.
- Assist in monitoring employee performance and identifying development opportunities and performance concerns.
- Conduct regular knowledge-sharing sessions and promote adoption of best practices across the team.
- Support development of training curricula, competency models, skill assessments, and career development pathways.
- Foster a collaborative, service-focused culture that promotes accountability, continuous learning, and operational excellence.
Subject Matter Expertise & Cross-Functional Leadership- Serve as the primary subject matter expert for Member Experience operations, onboarding, eligibility, account maintenance, service delivery processes, and specialty pharmacy programs.
- Provide guidance and support for complex operational scenarios, escalations, and member-impacting issues.
- Maintain expertise in program requirements, operational workflows, pricing structures, portal functionality, and related business processes.
- Act as the operational liaison between Member Experience, Sales, Contract Operations, Network, Product, IT, and other business partners.
- Represent Member Experience in cross-functional projects, operational reviews, and process improvement initiatives.
- Support implementation of new products, services, operational processes, and member experience enhancements.
Process Improvement, Automation & Operational Excellence- Lead process mapping, workflow optimization, and standardization initiatives across Member Experience operations.
- Identify opportunities to automate manual processes, streamline workflows, and improve operational efficiency.
- Partner with business stakeholders and technology teams to define, test, and implement automation solutions and system enhancements.
- Support ongoing enhancements to Salesforce, Mercury, member portals, and other operational technologies.
- Track recurring issues, conduct root cause analysis, and implement corrective actions to reduce rework and escalations.
- Develop, maintain, and enhance standard operating procedures, job aids, training materials, and process documentation.
- Lead initiatives designed to reduce operational friction, improve productivity, and enhance the member experience.
- Support future-state process design and operational scalability initiatives as Member Experience continues to evolve.
Quality, Metrics & Reporting- Establish and maintain quality standards for onboarding, eligibility, account maintenance, and member service activities.
- Monitor operational and service metrics, including cycle times, escalation volumes, first-contact resolution, rework rates, productivity measures, and member satisfaction indicators.
- Analyze performance data and operational trends to identify risks, opportunities, and process improvement recommendations.
- Develop reports, dashboards, and operational insights to support informed decision-making.
- Recommend corrective actions and continuous improvement initiatives based on performance results and trend analysis.
- Support departmental reporting, business reviews, and strategic operational initiatives.
What You'll Bring to the Table: - Bachelor's degree or equivalent combination of education and relevant experience.
- 5+ years of experience in member services, account management, customer success, healthcare operations, specialty pharmacy, or a related field.
- Prior experience leading, coordinating, or overseeing small teams of approximately 10 or fewer employees.
- Experience supporting recruitment, interviewing, onboarding, training, and employee development activities.
- Experience providing performance guidance, coaching, and day-to-day operational leadership.
- Experience leading cross-functional projects, operational improvement initiatives, and change management efforts.
- Experience identifying and implementing workflow automation and operational efficiency solutions.
Salary: The salary range for this role is $85,000 - $100,000.
This is the lowest to highest salary range for which this role has been evaluated. An employee's position within the salary range will be based on several factors which include, but not limited to education, qualifications, certifications, experience, skills, geographic location, and business or organizational needs.
We offer a comprehensive benefits package which includes:
Benefits:
- Medical, Dental, Vision Coverage (for employee and family)
- Flexible Spending Account & Health Savings Account with Company contribution
- Employee Assistance Program
- Disability Coverage
- Life insurance
- 401(k) with company match
- Employee Stock Purchase Plan (ESPP)
- Paid Time Off (PTO), paid holidays, floating days
Location: Onsite/Remote/Hybrid - as directed by your manager.
