manager customer experience support

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Job Duties/Responsibilities:

Operational Strategy & Project Leadership

• Leads high-impact operational initiatives that improve service level, quality, FCR, member satisfaction, retention, and regulatory compliance
• Translates organizational strategy into structured project plans with defined scope, milestones, owners, metrics, and accountability to ensure adoption
• Develop business cases and collaborates with Finance to create ROI analyses for operational enhancements
• Serves as project lead for cross-functional initiatives impacting the Customer Experience organization
• Ensures initiatives are scalable, repeatable, measurable, and sustainable

Driving True Ownership & First Call Resolution

• Leads enterprise focus on improving first call resolution and reducing repeat contacts
• Analyzes repeat call drivers, transfer patterns, grievance trends, and systemic barriers
• Designs workflow improvements that promote end-to-end issue resolution rather than task completion
• Partners with department leaders to eliminate friction points across systems, policies, and handoffs
• Establishes accountability mechanisms that reinforce ownership behaviors at all levels

Culture Enablement: Caring Connections

• Develop operational standards and service frameworks that embed empathy and caring connections into workflows
• Partners with Training and leadership to align coaching tools, quality scorecards/dashboards, and performance expectations with ownership and service excellence behaviors
• Ensure operational processes support compassionate, seamless member interactions
• Reinforces behaviors that reduces member effort and builds trust

Cross-Functional Collaboration & Matrix Leadership

• Partners with SMEs across Claims, Enrollment, Provider Relations, Appeals & Grievances, IT, Compliance, Quality, and Workforce Management
• Leads with strong influence and collaboration to drive alignment, remove barriers, and achieve measurable outcomes
• Facilitates structured and action focused documented working sessions to address systemic issues impacting member experience
• Establishes clear accountability matrices (RACI models) for operational initiatives
• Escalate barriers requiring executive alignment while maintaining solution ownership

Performance Analytics & Reporting

• Defines and monitors KPIs including:
  • First Call Resolution (FCR)
  • CMS service level standards
  • Quality and documentation accuracy
  • Member Satisfaction / CAHPS and Stars outcomes
  • Repeat contact rate
  • Call drivers and transfer trends
• Develops executive-level dashboards and performance summaries
• Translates analytics into structured improvement plans
• Identifies emerging risks and proactively recommends mitigation strategies

Process Optimization & Technology Enablement

• Participates in CRM development, optimization, and system implementation initiatives
• Evaluates contact center technology enhancements that improve leadership tools, resolution and efficiency
• Standardizes workflows to reduce variability and improve consistency
• Ensure documentation, training, and adoption plans are in place for new processes
• Aligns operational improvements with scalability and future growth needs

Regulatory & Compliance Alignment

• Ensure operational initiatives align with CMS Call Center Metrics and Medicare Managed Care regulations
• Partners with Compliance and Quality to support audit readiness and monitoring controls
• Reviews grievance and complaint trends to identify systemic gaps
• Designs process controls that reinforce documentation accuracy and HIPAA compliance and regulatory requirements

Direct People Leadership

When assigned direct reports, responsibilities include:

• Directly managing Supervisors and/or Customer Experience Specialists
• Establishing clear and documented performance expectations aligned to FCR, quality, KPI ex. service level, adherence, and member satisfaction
• Conducting regular 1:1 meetings focused on performance outcomes and professional development with clearly defined actions
• Providing timely and documented coaching, feedback, recognition, and performance management as necessary.
• Overseeing hiring selection, onboarding, engagement, and succession planning.
• Reinforcing a culture of caring connections and true ownership across all levels of the team
• Ensuring consistent application of policies, regulatory standards, and accountability practices

Leadership Model

• Primary: Operational and matrix leadership driving cross-functional execution
• Secondary: Direct people leadership of Supervisors and/or frontline staff
• Accountable for initiative outcomes, performance improvement, scalability, and sustainable implementation regardless of reporting structure

Supervisory Responsibilities:

• May include Direct people leadership of Supervisors and/or frontline staff

Job Requirements:

Experience:

Required:

• Minimum five (5) years of Call Center or Member Services experience
• Minimum three (3) years leading operational initiatives or managing teams in a compliance-driven industry
• Demonstrated success improving KPIs such as FCR, service level, quality, or member satisfaction
• Experience in Medicare Advantage or Managed Care environment

Preferred:

• Experience leading matrixed teams without direct authority
• Experience managing Supervisors and layered leadership structures
• Experience in grievance and appeals operations
• Experience with CRM implementation or contact center system enhancements
• Experience in remote or hybrid contact center environments

Education:

• Required: High School Diploma or GED.  

• Preferred: Bachelor’s degree in Healthcare Administration, Business, Operations Management, or related field

Specialized Skills & Competencies

• Strong knowledge of Medicare Advantage and CMS Call Center Metrics
• Advanced analytical and performance interpretation skills
• Strong project management and change management capabilities
• Demonstrated ability to lead through influence and, when required, through direct authority
• Expertise in root cause analysis and process improvement
• Strong stakeholder management and executive communication skills
• Proficiency in CRM systems, workforce management tools, reporting platforms, and Microsoft Office Suite
• Bilingual (English/Spanish) preferred

Language Skills

Ability to analyze regulatory documents, prepare executive-ready reports, and communicate complex operational insights clearly and effectively to diverse audiences

Mathematical & Analytical Skills

Ability to calculate and interpret call center metrics, trends, forecasts, and performance improvement impacts

Reasoning Skills

Ability to manage complex operational challenges involving multiple stakeholders and systems, identify root causes, and implement scalable solutions within a regulated environment

Work Environment

May be remote or hybrid. Requires:

• Reliable internet connectivity
• Ability to manage multiple concurrent projects
• Strict adherence to HIPAA and confidentiality standards

Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.  While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.