Resolution Response Specialist

Job Description

Job Description

Maven Clinic is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Through Maven Enterprise, the company partners with more than 2,300 employers and health plans to provide end-to-end women's and family health programs spanning fertility and family building, maternity and newborn care, parenting and pediatrics, and menopause and midlife — improving clinical outcomes, reducing healthcare costs, and expanding equitable access to high-quality care at scale. Through its consumer platform, Maven provides direct access to virtual care across 30+ specialties, as well as dedicated hormone and GLP-1 care programs purpose-built for women. Founded in 2014 by CEO Kate Ryder, Maven Clinic has raised more than $425 million from leading healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. Recognized for innovation and industry leadership, Maven has been named to the TIME100 Most Influential Companies, CNBC Disruptor 50, Fast Company's Most Innovative Companies, and FORTUNE Best Places to Work. Learn more at mavenclinic.com

An award-winning culture working towards an important mission –  Maven Clinic is a recipient of over 30 workplace and innovation awards, including: 

• TIME 100 Most Influential Companies (2023, 2026)
• Fortune Change the World (2024)
• CNBC Disruptor 50 List (2022, 2023, 2024)
• Fortune Best Workplaces for Millennials (2024)
• Fortune Best Workplaces in Health Care (2024)
• Fast Company Most Innovative Companies (2020, 2023)
• Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)

About the Role: 

Maven is looking for a Resolution Response Specialist who will lead the end-to-end resolution of complex, high-risk member escalations, serving as a Tier 2 senior owner within the Resolution Response Team to ensure every escalation is handled consistently, efficiently, and at the right level the first time — restoring member trust while protecting Maven, its clients, and its members.

This is a non-exempt, Monday–Friday position with hours of 8:30 a.m.–5:00 p.m. ET and occasional weekend coverage as needed.

What You'll Do:

• Own escalated member cases end-to-end, serving as the single accountable owner for moderate-to-high complexity issues across billing, reimbursement, benefits, coordination of benefits, network exceptions, and service breakdowns.
• Conduct structured investigations using the established triage framework (Category → Owner → Macro → Checklist → SLA → Escalation Path), reviewing ticket history, call recordings, prior guidance, client documentation, spend, and reimbursement records before resolution.
• Lead service recovery by reviewing low-rated interactions, conducting proactive outreach (call-first where possible), applying de-escalation protocols, and confirming closed-loop resolution with a written member recap.
• Serve as the primary cross-functional bridge across MBS, Support, Care Delivery, Client Success, Payment Operations, Network Operations, Product, Engineering, and Legal/Compliance to coordinate corrective action and accelerate resolution.
• Communicate with members using approved macros and empathy-led, legally protective language; provide CSMs with concise case summaries and polished client-facing messaging when needed.
• Identify and route risk using Critical/High/Standard severity and SEV 2/SEV 3 legal protocols for legal, compliance, discrimination, or regulatory exposure.
• Maintain precise documentation in Zendesk and the escalation tracker, applying granular themes, reason codes, and ownership tags to enable reliable root-cause reporting.
• Identify escalation trends and drive macro, playbook, and process improvements that reduce recurrence and prevent repeat escalations.

What You'll Bring: 

• Bachelor's degree in Healthcare Administration, Business, Communications, or related field preferred, or equivalent experience; 3+ years in escalation management, member/customer advocacy, health benefits, or healthcare operations.
• Experience resolving complex, multi-stakeholder escalations; strong knowledge of employer-sponsored benefits, reimbursement and claims workflows, and the fertility/family-building member journey.
• Familiarity with Zendesk, Jira, Guru, Google Sheets, and Looker.
• Highly organized and detail-oriented, with strong critical thinking, root-cause analysis, and structured case management skills.
• Excellent verbal and written communication, with strong de-escalation skills and the ability to translate complex benefits and billing issues into clear resolution plans.
• Sound legal and risk judgment, with the ability to identify when to involve Legal, Compliance, or leadership and collaborate effectively across teams.
• Empathetic, composed, and member-centric, with the ability to navigate high-emotion, high-stakes cases through resolution.

The base salary range for this role is $82,000 - $96,000 per year. You will also be entitled to receive equity and benefits. Individual pay decisions are based on a number of factors, including qualifications for the role, experience level, and skillset.

This role requires active work authorization in the US.

Maven embraces a flexible and inclusive work environment. This role is open to candidate in: AZ, DC, DE, FL, GA, HI, IL, KS, MA, MD, ME, MI, MN, MO, NC, NJ, NM, NV, NY, OH, OR, PA, SC, TN, TX, VA, VT, WI. Maven is committed to supporting remote team members with the tools and collaborative culture needed to thrive regardless of location. This policy reflects our belief that great work can happen anywhere and that flexibility enables our team to do their best work.

At Maven we believe that a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you do not have experience in all of the areas detailed above, we hope that you will share your unique background with us in your application and how it can be additive to our teams.

Benefits That Work For You

Our benefits are designed to support your health, well-being and career development, helping you thrive both personally and professionally. We remain focused on providing a competitive benefits package for our employees. On top of standards such as employer-covered health, dental, and insurance plan options, we offer an inclusive approach to benefits:

• Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics.
• Whole-self care through wellness partnerships
• Hybrid work, in office meals, and work together days 
• 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+)
• Annual professional development stipend and access to a personal career coach through Maven for Mavens
• 401K matching for US-based employees, with immediate vesting

These benefits are applicable to Maven Clinic Co., US-based, full-time employees only. 1099/Contract Providers are ineligible for these benefits. 

Maven is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Maven is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Maven Clinic interview requests and job offers only originate from an @mavenclinic.com email address (e.g View email address on ziprecruiter.com). Maven Clinic will never ask for sensitive information to be delivered over email or phone. If you receive a scam issue or a security issue involving Maven Clinic please notify us at: View email address on ziprecruiter.com. For general and additional inquiries, please contact us at  View email address on ziprecruiter.com.