Job Description

Operational Leadership:

• Manage daily operations, ensuring smooth workflow and maximum efficiency.
• Supervise the management of member cases, ensuring all issues are resolved in a timely and satisfactory manner.
• Monitor case workflows and resolve complex or escalated issues to maintain high service standards.
• Monitor call volume and performance metrics, making necessary adjustments to meet and exceed service goals.
• Ensure adherence to organizational policies, procedures, and relevant healthcare regulations.
• Conduct regular performance reviews, provide constructive feedback, and implement training programs to address skill gaps.

Process Improvement and Problem-Solving:

• Manage the resolution of complex member inquiries and issues, ensuring prompt and effective solutions.
• Implement and refine best practices and procedures to enhance efficiency, effectiveness, and member satisfaction.
• Immerse yourself in VIVIO’s processes and procedures, first for understanding and execution, then for continuous enhancement.
• Provide guidance and support to team members dealing with challenging cases, leveraging your expertise.
• Conduct root cause analysis for significant case escalations and drive continuous improvement initiatives.

Team Management and development:

• Lead, motivate, and develop the team to achieve individual and team goals.
• Conduct regular performance reviews, provide constructive feedback, and implement training programs to address skill gaps.
• Promote a positive and collaborative team environment, encouraging open communication and professional growth.

Performance Monitoring:

• Track key performance indicators (KPIs), conduct regular audits and prepare regular reports on team performance.
• Use data-driven insights to make informed decisions and drive continuous improvement.

Communication and Collaboration:

• Facilitate clear, effective communication within the team, ensuring alignment with goals and expectations.
• Collaborate with healthcare providers, pharmacies, and other departments to address member inquiries and concerns efficiently.
• Share updates, discuss challenges, and celebrate team successes to foster a cohesive and motivated team environment.
• Provide individualized support to team members, promoting open dialogue and addressing emerging issues.
• Work with cross-functional teams to achieve common goals, facilitate communication, and drive project success by leveraging diverse perspectives and expertise.

Qualifications

• Strong track record of successfully leading and developing teams, with excellent interpersonal and communication skills.
• At least 5 years of experience in the healthcare industry, with a focus on care coordination, member advocacy, or related roles.
• Minimum of 5 years of member service leadership and case management experience, within a healthcare setting; remote call center experience highly preferred.
• Education: An associate’s degree or higher in business administration, management, or a related field is required.
• Travel: Must be willing to travel occasionally for business purposes, including meetings, site training, or VIVIO-related events
• Availability to work a full-time schedule between business operating hours of 9 am-8 pm ET and flex based on business needs.
• Proven ability to thrive in a high-volume, fast-paced, and evolving team environment. Prior experience in a call center leadership role.
• Prior PBM experience nice to have
• Strong analytical and problem-solving abilities, focusing on resolving complex member inquiries and optimizing processes.
• Proficiency in Microsoft Office Applications (Word, PowerPoint, Excel, Outlook, Teams, etc.).
• Exceptional organizational skills with the ability to manage multiple tasks, prioritize effectively, and maintain attention to detail.
• An active problem solver with a “figure it out” mindset.
• A clear, effective, and proactive communicator.

Additional Information

• Base salary $ 68K-$75 K/year plus bonus eligible
• Health Benefits
• 401K employer match
• Stock Options
• PTO
• Opportunity to work for a growing and innovative company.
• Dynamic and collaborative work environment.
• The chance to make a real impact with a Public Benefit Corporation.

VIVIO Health is an Equal Opportunity Employer and does not unlawfully discriminate based on any status or condition protected by applicable federal, state, or local municipal law. All your information will be kept confidential according to EEO guidelines.