Senior Associate, Resolution Response Team

🔥 12 hours ago

🌵 Arizona, Florida, +23 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🌺 Hawaii – Remote 🌽 Illinois – Remote 🌪️ Kansas – Remote 🦞 Maine – Remote 🎰 Nevada – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote

💵 $82k - $96k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Maven Clinic

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2014

🏥 Healthcare

⚕️ Healthcare Insurance

📡 Telecommunications

Healthcare • Healthcare Insurance • Telecommunications

Maven Clinic is a pioneering telehealth provider dedicated to women's and family health. The company offers comprehensive support through various life stages, such as fertility, maternity, parenting, and menopause. Maven Clinic combines clinical expertise with an intuitive virtual care model to deliver improved health outcomes and lower costs for families around the world. With a focus on personalized care, it connects members to on-demand specialists to address their clinical, emotional, and financial needs seamlessly.

📋 Description

• Own escalated member cases end-to-end 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, reviewing ticket history, call recordings, prior guidance, client documentation, spend, and reimbursement records • Lead service recovery by reviewing low-rated interactions, conducting proactive outreach, 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 • 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 • Maintain precise documentation in Zendesk and the escalation tracker using granular themes, reason codes, and ownership tags • Identify escalation trends and drive macro, playbook, and process improvements to reduce recurrence and prevent repeat escalations

🎯 Requirements

• 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 • Strong critical thinking, root-cause analysis, and structured case management skills • Excellent verbal and written communication and strong de-escalation skills • Ability to translate complex benefits and billing issues into clear resolution plans • Sound legal and risk judgment • Ability to identify when to involve Legal, Compliance, or leadership • Ability to navigate high-emotion, high-stakes cases through resolution • Resourceful, solutions-oriented, and comfortable with shifting priorities • Active work authorization in the US

🏖️ Benefits

• Equity • Employer-covered health insurance • Dental insurance • Insurance plan options • Access to Maven’s virtual care platform and specialists, including mental health, reproductive health, family planning, and pediatrics • Wellness partnerships • Hybrid work • In-office meals • Work together days • 16 weeks 100% paid parental leave for employees with 1+ year of tenure • New parent stipend for employees with 1+ year of tenure • Annual professional development stipend • Personal career coach through Maven for Mavens • 401(k) matching for US-based employees, with immediate vesting