manager customer experience support

Alignment Health•Orange, CA

6d•$70,823 - $106,234•Hybrid

About The Position

Alignment Health is a healthcare company focused on serving seniors and the chronically ill. The Manager, Customer Experience Support Projects leads strategic operational initiatives to enhance the Customer Experience organization for members. This role focuses on driving improvements in call center performance, first call resolution (FCR), member issue ownership, and overall member experience. The position involves operational leadership through cross-functional collaboration, subject matter expert partnerships, and project execution. The Manager will identify process optimization opportunities, conduct root cause analysis, design sustainable solutions, and ensure effective implementation across departments. This role may also directly manage Supervisors and/or frontline Customer Experience Specialists, taking full responsibility for team performance, engagement, and results. The leader will build scalable systems to improve accountability and organizational capability, whether leading through influence or direct reporting relationships.

Requirements

Minimum five (5) years of Call Center or Member Services experience
Minimum three (3) years leading operational initiatives or managing teams in a compliance-driven industry
Demonstrated success improving KPIs such as FCR, service level, quality, or member satisfaction
Experience in Medicare Advantage or Managed Care environment
High School Diploma or GED
Strong knowledge of Medicare Advantage and CMS Call Center Metrics
Advanced analytical and performance interpretation skills
Strong project management and change management capabilities
Demonstrated ability to lead through influence and, when required, through direct authority
Expertise in root cause analysis and process improvement
Strong stakeholder management and executive communication skills
Proficiency in CRM systems, workforce management tools, reporting platforms, and Microsoft Office Suite
Ability to analyze regulatory documents, prepare executive-ready reports, and communicate complex operational insights clearly and effectively to diverse audiences
Ability to calculate and interpret call center metrics, trends, forecasts, and performance improvement impacts
Ability to manage complex operational challenges involving multiple stakeholders and systems, identify root causes, and implement scalable solutions within a regulated environment
Reliable internet connectivity
Ability to manage multiple concurrent projects
Strict adherence to HIPAA and confidentiality standards

Nice To Haves

Experience leading matrixed teams without direct authority
Experience managing Supervisors and layered leadership structures
Experience in grievance and appeals operations
Experience with CRM implementation or contact center system enhancements
Experience in remote or hybrid contact center environments
Bachelor’s degree in Healthcare Administration, Business, Operations Management, or related field
Bilingual (English/Spanish)

Responsibilities

Leads high-impact operational initiatives that improve service level, quality, FCR, member satisfaction, retention, and regulatory compliance.
Translates organizational strategy into structured project plans with defined scope, milestones, owners, metrics, and accountability to ensure adoption.
Develops business cases and collaborates with Finance to create ROI analyses for operational enhancements.
Serves as project lead for cross-functional initiatives impacting the Customer Experience organization.
Ensures initiatives are scalable, repeatable, measurable, and sustainable.
Leads enterprise focus on improving first call resolution and reducing repeat contacts.
Analyzes repeat call drivers, transfer patterns, grievance trends, and systemic barriers.
Designs workflow improvements that promote end-to-end issue resolution rather than task completion.
Partners with department leaders to eliminate friction points across systems, policies, and handoffs.
Establishes accountability mechanisms that reinforce ownership behaviors at all levels.
Develops operational standards and service frameworks that embed empathy and caring connections into workflows.
Partners with Training and leadership to align coaching tools, quality scorecards/dashboards, and performance expectations with ownership and service excellence behaviors.
Ensures operational processes support compassionate, seamless member interactions.
Reinforces behaviors that reduce member effort and build trust.
Partners with SMEs across Claims, Enrollment, Provider Relations, Appeals & Grievances, IT, Compliance, Quality, and Workforce Management.
Leads with strong influence and collaboration to drive alignment, remove barriers, and achieve measurable outcomes.
Facilitates structured and action-focused documented working sessions to address systemic issues impacting member experience.
Establishes clear accountability matrices (RACI models) for operational initiatives.
Escalates barriers requiring executive alignment while maintaining solution ownership.
Defines and monitors KPIs including: First Call Resolution (FCR), CMS service level standards, Quality and documentation accuracy, Member Satisfaction / CAHPS and Stars outcomes, Repeat contact rate, Call drivers and transfer trends.
Develops executive-level dashboards and performance summaries.
Translates analytics into structured improvement plans.
Identifies emerging risks and proactively recommends mitigation strategies.
Participates in CRM development, optimization, and system implementation initiatives.
Evaluates contact center technology enhancements that improve leadership tools, resolution and efficiency.
Standardizes workflows to reduce variability and improve consistency.
Ensures documentation, training, and adoption plans are in place for new processes.
Aligns operational improvements with scalability and future growth needs.
Ensures operational initiatives align with CMS Call Center Metrics and Medicare Managed Care regulations.
Partners with Compliance and Quality to support audit readiness and monitoring controls.
Reviews grievance and complaint trends to identify systemic gaps.
Designs process controls that reinforce documentation accuracy and HIPAA compliance and regulatory requirements.
Directly managing Supervisors and/or Customer Experience Specialists (when assigned direct reports).
Establishing clear and documented performance expectations aligned to FCR, quality, KPI ex. service level, adherence, and member satisfaction (when assigned direct reports).
Conducting regular 1:1 meetings focused on performance outcomes and professional development with clearly defined actions (when assigned direct reports).
Providing timely and documented coaching, feedback, recognition, and performance management as necessary (when assigned direct reports).
Overseeing hiring selection, onboarding, engagement, and succession planning (when assigned direct reports).
Reinforcing a culture of caring connections and true ownership across all levels of the team (when assigned direct reports).
Ensuring consistent application of policies, regulatory standards, and accountability practices (when assigned direct reports).