Remote Customer Resolution Supervisor

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:

Team Leadership & Development

• Directly lead, coach, and develop Resolution Specialists handling outbound engagement, escalations, and complex member issues
• Foster a culture of caring connections, accountability, and ownership of “one connection” mindset
• Conduct regular and documented coaching sessions, quality reviews, and performance discussions outlining improvement actions and recognizing success
• Drive employee engagement, professional growth, and succession readiness
• Partner with the Manager on hiring, onboarding, and corrective action when needed

Operational Execution

• Oversee daily case management operations to ensure timely and complete resolution of member concerns
• Improve case closure turnaround times and reduce unresolved and aging inventory
• Monitor individual productivity, quality, and member satisfaction metrics to ensure performance targets are met
• Ensure compliance with CMS and regulatory requirements in all resolution activities
• Identify and remove operational barriers that delay case resolution

Performance & Continuous Improvement

• Track, analyze and address team and individual KPIs including turnaround time, closure rates, quality scores, repeat contacts, and productivity
• Use root cause analysis to identify trends driving complaints, escalations, and disenrollment risk
• Implement process improvements that reduce repeat issues and improve first-time resolution
• Support scalable workflow enhancements to accommodate membership growth without sacrificing service quality
• Provide regular performance insights and action plans to Manager

Cross-Functional Collaboration

• Partner with internal departments (ex. Operations, Clinical, Enrollment, Claims, Compliance) to resolve open cases and address systemic issues
• Escalate trends and systemic root causes to leadership with recommended solutions
• Coordinate with Workforce Management on capacity needs, schedules and adherence
• Collaborate on improvements to CRM and case management tools to increase efficiency and visibility
• Contribute to enterprise-wide service recovery and disenrollment prevention efforts

Supervisory Responsibilities:

• Directly lead, coach, and develop Resolution Specialists handling outbound engagement, escalations, and complex member issues

Job Requirements:

Experience:

Required:

• 3+ years of experience in healthcare contact center, member services, grievance, or escalation environments
• 2+ years of frontline leadership experience managing teams in a compliance-driven setting
• Demonstrated success improving turnaround times, closure rates, and operational KPIs
• Strong understanding of regulatory and compliance standards with CMS experience preferred

Preferred:

• Medicare Advantage or managed care experience
• Experience leading resolution or complex case management teams

Education:

• Required: High School diploma with required work experience

• Preferred: Bachelor’s degree in healthcare administration, business, or related field

Specialized Skills & Competencies

Key Competencies

• Serving-heart leadership with strong accountability
• Ability to coach for both empathy and performance
• Operational discipline and data-driven decision making
• Strong cross-functional partnership skills
• Root cause problem-solving mindset
• Change agility and ability to lead through growth
• Commitment to scalable, sustainable solutions

Success Profile

In this role, success means:

• Members experience compassionate, proactive, and fully owned resolution
• Case turnaround times consistently improve
• Aging inventory and repeat contacts decrease
• Specialists demonstrate strong engagement and accountability
• Systemic issues are identified and addressed through cross-functional collaboration
• Operational processes scale effectively as membership grows

This position serves as a critical bridge between frontline execution and strategic direction, ensuring operational excellence and caring connections are consistently delivered at scale.

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 accommodation 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.