Customer Success Lead

Overview Alignment Health is committed to serving seniors and the chronically ill. We build a passionate, caring team focused on putting the senior first and delivering high‑quality, low‑cost care every day. Responsibilities Escalation Ownership & Service Recovery Excellence Take full ownership of complex, urgent, and high‑visibility member escalations including executive and market‑leader cases. Lead service recovery with empathy, active listening, and trust restoration. Serve as the primary point of contact from intake through resolution, ensuring accuracy, compliance, and alignment with organizational tone. Partner cross‑functionally to remove barriers and drive resolution for escalations requiring coordination across departments. Operational Support Maintain a “working” role by handling inbound and outbound member interactions in line with productivity and service‑level goals. Support daily triage, prioritization, and timely follow‑up of escalation cases. Monitor active cases to ensure adherence to SLAs, quality standards, and service recovery expectations. Address complaints and grievances in accordance with Medicare Managed Care requirements and internal procedures. Frontline Team Support & Enablement Act as a subject‑matter expert and primary resource for specialists with real‑time guidance, coaching, and escalation support. Assist with onboarding, nesting support, live call monitoring, and guidance to ensure readiness and confidence. Foster a culture of empathy, accountability, and high standards of member care. Performance Monitoring & Continuous Improvement Monitor individual and team performance across productivity, quality, and service metrics. Identify trends in escalations and member feedback; provide insights and recommendations to leadership. Partner with training and leadership to identify skill gaps and support ongoing development initiatives. Contribute to process improvement efforts aimed at reducing escalations, increasing efficiencies, and improving the overall member experience. Collaboration & Communication Collaborate closely with the Supervisor, Customer Success to align priorities, escalations, and team performance. Maintain clear, professional, and effective communication with internal stakeholders, including leadership and cross‑functional partners. Support reporting needs related to escalation trends, risks, and service recovery outcomes. Compliance & Confidentiality Maintain strict adherence to HIPAA, privacy, and data security standards. Ensure all member interactions and case documentation meet regulatory and organizational compliance requirements. Other Responsibilities Assist with monitoring attendance and schedule adherence. Encourage a culture of accountability, collaboration, and continuous improvement. Perform other duties as assigned and support the Supervisor, Customer Success in day‑to‑day oversight. Job Requirements Experience Strong knowledge of Medicare Managed Care plans required. 3+ years of customer service experience required (healthcare preferred). Previous lead or equivalent experience required. Experience handling complex or executive‑level escalations strongly preferred. Bilingual (English/Spanish) preferred. Education High school diploma or GED with relevant work experience required. Bachelor’s degree in Healthcare Administration, Business, or related field with relevant work experience preferred. Training No training required. Specialized Skills Working knowledge of Microsoft Excel, PowerPoint, SharePoint, and Power BI. Experience with Microsoft Teams and case management systems. Strong communication skills with the ability to bridge people, process, and technology. Demonstrated ability to handle high‑pressure situations with professionalism and sound judgment. Strong ownership mindset and accountability. Empathy and emotional intelligence in high‑stress interactions. Conflict resolution and de‑escalation expertise. Critical thinking and problem‑solving skills. Ability to influence and support peers without direct authority. Licensure No license required. Essential Physical Functions Regularly required to sit; use hands to finger, handle, or feel and talk or hear. Frequently required to walk; stand; reach with hands and arms. Occasionally required to climb or balance and stoop, kneel, crouch, or crawl. Occasionally required to lift and/or move up to 20 pounds. Work Environment Environment characterized by reasonable accommodations for individuals with disabilities. Pay Range $44,790.00 – $67,185.00, based on location, education, responsibilities, experience, etc. EEO Statement 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. 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