Sr. Specialist, Member Experience Team Lead

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Sr. Specialist, Member Experience Team Lead based in United States.

This is a senior operational leadership opportunity for an experienced member experience or healthcare operations professional.

You will serve as the functional lead for a high-performing Member Experience team, providing day-to-day guidance and operational oversight.

The role combines team coaching, subject matter expertise, workflow coordination, and cross-functional collaboration.

You will play a key role in improving service quality, operational efficiency, and the overall member experience.

The position offers significant opportunities to lead process improvement, automation, and technology enhancement initiatives.

You will work closely with teams across Sales, Operations, Product, IT, and other business functions to deliver scalable solutions.

Success in this role requires strong leadership without direct reporting authority, sound judgment, and a continuous improvement mindset.

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.