Member Services Team Lead – Medication Access & Support Programs

Skills

About the Role

You will lead frontline Member Services Associates supporting a medication access and pharmacy-supported care program. You will own real-time chat and phone queue execution, monitor coverage and workload, and handle complex cases when needed. You will coach associates, conduct quality reviews, support onboarding, and serve as the first escalation point for pharmacy and insurance issues. You will ensure consistent use of SOPs and workflows, identify operational risks, help implement tooling changes, and support response time, resolution quality, and member satisfaction.

Requirements

• 2–4 years of experience in healthcare support, pharmacy operations, insurance navigation, or related fields.
• Prior experience coaching, mentoring, or acting as a senior or lead in a frontline environment.
• Strong understanding of pharmacy workflows, insurance coverage concepts, and medication access processes.
• Ability to handle escalations and emotionally charged member situations.
• Strong written and verbal communication skills.
• Ability to balance hands-on work with people leadership.

Responsibilities

• Own real-time execution across chat and phone queues during assigned shifts.
• Monitor queue health, coverage, and workload distribution to ensure timely responses.
• Handle complex cases and volume spikes as needed.
• Support and coach Member Services Associates on judgment calls, prioritization, and ambiguous cases.
• Conduct quality reviews and deliver actionable feedback.
• Support onboarding and ramping of new hires.
• Resolve first-line pharmacy and insurance escalations.
• Partner with internal teams to resolve escalated member issues while maintaining non-clinical boundaries.
• Ensure appropriate escalation of safety concerns and sensitive disclosures.
• Ensure consistent execution of SOPs, scripts, and workflows.
• Identify workflow breakdowns and flag patterns or risks to leadership.
• Help test, roll out, and reinforce new workflows, macros, and tooling changes.
• Support performance across response time, resolution quality, and member satisfaction.

Benefits

• Employer-covered health, dental, and insurance plan options.
• Access to the Maven platform and specialists for mental health, reproductive health, family planning, and pediatrics.
• Wellness partnerships.
• Hybrid work.
• In-office meals.
• 16 weeks of 100% paid parental leave and a new parent stipend for eligible employees.
• 401K matching with immediate vesting for US-based employees.