Full-Time Escalations Manager -Member Experience

Overview: We are seeking a proactive and results-driven Escalation Manager to join our team, focusing on handling patient care coordination escalations, identifying root causes, and ensuring smooth prioritization of issues. You will work to eliminate delays in members receiving their medications and ensure continuous improvement in our processes. This is an individual contributor role with opportunities to make an impact and grow. As a key member of the team, you will drive operational efficiency while leading initiatives to improve member experience.

Key Responsibilities:

1. Escalation Management and Prioritization: Experience in identifying, prioritizing, and managing high-priority issues, ensuring timely and effective resolutions for complex concerns. Act as a primary point of contact for escalated cases, ensuring smooth communication and swift problem-solving. Analyze and identify root causes of recurring issues to prevent future escalations. Prioritize issues based on urgency and impact, ensuring critical cases are addressed first, minimizing member disruptions.
2. Operational Leadership & Process Optimization: Manage day-to-day project workflows to optimize team performance and ensure timely issue resolution. Collaborate with team members to streamline processes, eliminating bottlenecks that delay medication fills or other member services. Implement process improvements to enhance operational efficiency, focusing on member satisfaction and case resolution. Ensure all processes adhere to organizational policies, procedures, and healthcare regulations.
3. Performance Monitoring & Reporting: Track key performance metrics (KPIs) for case resolution, member satisfaction, and operational efficiency. Conduct regular audits to assess performance, identify improvement areas, and create action plans. Provide data-driven insights and recommendations to leadership to ensure team goals are met.
4. Team Support & Development: Provide guidance and support to team members working on escalated cases, fostering a problem-solving mindset. Collaborate with other Operation leaders and the trainer to ensure team members have the skills to handle complex inquiries effectively.
5. Collaboration & Communication: Foster effective communication across teams, ensuring clear understanding of project goals and updates. Work cross-functionally with other departments (e.g., healthcare providers, pharmacies) to resolve member issues and optimize service delivery. Proactively communicate with leadership on progress, challenges, and solutions to maintain alignment.

Qualifications:

• 5 years of experience in healthcare, with a focus on escalation resolution, care coordination, member advocacy, or case management.
• Prior experience in Rx management/Pharmacy Patient Care Coordination is highly preferred.
• Minimum 5 years of experience leading teams in a healthcare or remote call center setting.
• Strong analytical and problem-solving skills with the ability to resolve complex issues and drive process improvements.
• Experience in handling escalations and optimizing operational workflows.
• Demonstrate a strong commitment to being available for a role that requires on-call readiness.
• Excellent communication skills, with the ability to articulate complex issues and solutions to stakeholders at all levels.
• Strong organizational skills and the ability to prioritize multiple tasks effectively.
• Proficiency in Microsoft Office Applications (Word, PowerPoint, Excel, Outlook, Teams).
• An active problem-solver with a “figure it out” mindset.
• Availability to travel for VIVIO-related meetings, and training as needed.
• An associate's degree or higher in business administration, management, or a related field is required. A bachelor’s degree is preferred.

Compensation & Benefits:

• Base Salary: $70-85K/year
• Bonus
• Health benefits
• 401K with employer match
• Stock options
• PTO
• Opportunity to work in a fast-moving, collaborative, and innovative company

Company Information: VIVIO Health is an Equal Opportunity Employer. All information will be kept confidential according to EEO guidelines. Job opportunities will only be extended after a candidate submits a completed job application and undergoes a thorough interview process. All legitimate correspondence from a VIVIO employee will come from our Smart Recruiter Applicant Tracking System "@smartrecruiter.com" or "@viviohealth.com" email accounts.

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