Remote-Supervisor, Customer Reimbursement and Digital

Alignment Health

1d • Remote

About The Position

As part of the broader Resolution team, this Remote Supervisor is a frontline leader primarily responsible for guiding a team of Customer Experience Resolution and Reimbursement Specialists who support members through digital engagement channels and reimbursement processing functions. Reporting directly to the Director, Customer Resolution, this role translates strategic priorities into daily execution, ensuring caring connections, timely member responses, strong regulatory compliance, and operational excellence. The Supervisor leads the team to take full ownership of member inquiries across digital channels and reimbursement requests while ensuring clear communication, accurate documentation, and efficient case handling. The ideal leader blends empathy with operational discipline, driving both exceptional service and measurable performance outcomes.

Requirements

• 5+ years of healthcare contact center, member services, or resolution experience within a managed care organization.
• Familiarity with grievances, appeals, Direct Member Reimbursements, and CMS-regulated environments.
• Working knowledge of Medicare Managed Care (Parts C and D) and CMS compliance requirements.
• Strong understanding of case management workflows and turnaround time management.
• Ability to coach for empathy, clarity, ownership, and resolution effectiveness.
• Analytical mindset with ability to identify trends and root causes using performance data.
• Excellent written and verbal communication skills, particularly in digital channels.
• Strong organizational skills with the ability to manage competing priorities.
• Ability to balance compassion with operational rigor in a fast-paced environment.
• Reliable internet connectivity
• Ability to manage multiple concurrent projects
• Strict adherence to HIPAA and confidentiality standards

Nice To Haves

• 2+ years of supervisory or team lead experience preferred.
• Experience supporting Medicare Advantage populations strongly preferred.
• Bachelor’s degree in healthcare administration, business, or related field preferred.
• Equivalent combination of education and experience may be considered.
• Bilingual (English/Spanish) preferred.

Responsibilities

• Lead and coach the Digital and Member Reimbursement Specialist by supporting digital member communications and reimbursement processing.
• Foster a culture of caring connections, accountability, and service excellence aligned with Alignment’s serving-heart culture.
• Set clear performance expectations tied to quality, turnaround time, productivity, compliance, and member satisfaction.
• Conduct regular coaching sessions, case reviews, and quality audits to ensure high standards of service and documentation accuracy in accordance with established criteria and policies.
• Support onboarding, training, and continuous skill development to strengthen regulatory knowledge and digital service capabilities.
• Identify opportunities to improve and optimize workflows, reduce processing delays, and enhance the member experience.
• Escalate regulatory or process concerns promptly and partner with leadership to implement improvements.
• Monitor day-today operational performance metrics including productivity, turnaround time, quality scores, documentation accuracy, and member satisfaction to ensure meets response time and reimbursement case aging with accuracy to maintain procedural, compliance and audit readiness.
• Analyze operational trends to identify opportunities for coaching, process improvement, and efficiency gains.
• Develop and implement action plans to improve productivity, quality, and service outcomes.
• Support accurate and timely operational reporting aligned with organizational standards and compliance requirements.
• Contribute to scalable process improvements that support organizational growth and operational efficiency.
• Ensure timely responses to member inquiries while maintaining quality, empathy, and regulatory compliance.
• Monitor verbal and written communications to ensure clarity, professionalism, and alignment with brand and service standards.
• Reinforce digital adoption by coaching Specialists to guide members toward efficient service channels when appropriate.
• Ensure all member interactions are accurately documented in CRM systems in accordance with organizational, CMS and regulatory requirements.
• Partner with Operations, Technology, Compliance, and other internal teams to resolve member issues and improve service processes.
• Participate in cross-functional discussions to enhance workflows, reduce friction points, and improve the overall member experience.
• Escalate recurring operational issues with data-backed insights and proposed solutions.
• Support continuous improvement initiatives that enhance digital service delivery and reimbursement processing efficiency.
• Directly supervises Specialists supporting digital member communications and reimbursement processing functions. May expand to other Resolution Specialist based on operational needs.
• Responsible for hiring support, onboarding, coaching, performance management, recognition, and corrective action as needed.
• Ensures team compliance with Alignment policies, CMS regulations, and applicable laws.
• Maintains a strong culture of engagement, accountability, and professional development.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees