Remote Operations Lead, Member Experience

Jobgether; United States; Remote; USD 75,000 - 85,000; Full time

Benefits offered by this job

Health benefits

401(k) plan with employer match

Stock options

PTO for personal needs and work-life

Job summary

Jobgether in the United States seeks an Operations Manager - Member Experience to oversee issue resolution, QA, and continuous improvement in healthcare operations. You will manage escalations, drive root cause analysis, and coach teams to deliver compliant, member-first support in a remote setting.

You will optimize AI-powered tools, monitor SLAs, and collaborate with clients, consultants, and vendors to improve medication access and member experience.

Qualifications

• 3+ years in member experience or PBM operations.
• Experience managing teams in a queue-based/CC environment.
• Knowledge of HIPAA requirements and healthcare regulations.
• Experience presenting operational insights to clients or executives.

Responsibilities

• Oversee member issue resolution and escalations.
• Lead quality assurance and compliance activities (audits, scorecards, training).
• Guide AI tool usage and optimization.
• Coach team leads and staff; manage scheduling and performance objectives.

Skills

CRM platforms

Excel pivot tables

Claims management systems

Analytical thinking

Communication

Education

High school diploma or equivalent

Bachelor's degree in healthcare administration or related field

Tools

Microsoft Excel

CRM software

Job description

Jobgether in the United States seeks an Operations Manager - Member Experience to oversee issue resolution, QA, and continuous improvement in healthcare operations. You will manage escalations, drive root cause analysis, and coach teams to deliver compliant, member-first support in a remote setting.

You will optimize AI-powered tools, monitor SLAs, and collaborate with clients, consultants, and vendors to improve medication access and member experience.