Imagine360 is seeking a Supervisor, Digital Resolution Team to join the team!
The Supervisor, Member Escalations & Benefits Correspondence is responsible for overseeing escalated member issues and supervising staff who manage written benefit-related inquiries. This role ensures timely, accurate, and high‑quality responses to both escalated call situations and benefits correspondence while maintaining white‑glove service standards. The Supervisor provides daily guidance, coaching, quality oversight, and operational support to ensure team efficiency, accuracy, and adherence to organizational service expectations.
This position requires exceptional communication, strong problem‑solving skills, and the ability to calmly navigate high‑visibility escalations while supporting team members in delivering an effortless member and provider experience.
Position Location: 100% remote
Responsibilities include but are not limited to:
Supervisory Responsibilities:
- Provide day‑to‑day coaching, support, and development to staff handling escalations and benefits correspondence.
- Conduct regular performance evaluations and monitor quality, productivity, and adherence goals.
- Deliver corrective action when appropriate, including coaching, documentation, and follow‑up.
- Lead monthly team meetings, 1:1s, and ongoing development conversations.
- Serve as the primary point of contact for questions, escalation assistance, and process clarification.
Escalations Oversight:
- Manage escalated or sensitive member issues requiring advanced intervention beyond frontline agents.
- Review and triage escalations to determine next steps, partnering with internal teams (Client Experience, Medical Management, Provider Services, Correspondence).
- Ensure urgent vs. non‑urgent escalation criteria are followed and response expectations are met.
- Provide wrap‑up communication to leadership as appropriate for high‑visibility cases.
Benefits Correspondence Oversight:
- Oversee staff responsible for written inquiries regarding benefits, claims status, eligibility, predeterminations, and other benefit‑related requests.
- Ensure outgoing correspondence meets quality, accuracy, and compliance standards.
- Maintain service metrics including schedule adherence, email quality, production goals, and turnaround times.
- Support staff in resolving complex benefit inquiries requiring research or collaboration across departments.
Team Management & Workflow Coordination:
- Distribute and monitor daily workloads to ensure appropriate coverage across correspondence and escalations.
- Track team productivity and quality, providing targeted coaching where needed.
- Review quality audits and guide staff toward performance improvements.
- Coordinate incoming work queues and ensure efficiency across functions.
Process & Quality Improvement:
- Identify opportunities to streamline processes and recommend enhancements to improve efficiency and member experience.
- Partner with leadership on new system/process implementations impacting escalations or correspondence.
- Ensure SOPs, training materials, and workflows are followed and provide feedback for improvements.
Communication & Collaboration:
- Act as liaison between Member Services, Correspondence, Provider Services, Clinical teams, and other stakeholders.
- Communicate trends, issues, and updates to leadership, recommending action steps.
- Support cross‑departmental resolution of high‑impact issues.
Required Experience/Education:
- Experience in benefits, claims, correspondence, member services, or healthcare operations required.
- Proven subject matter experience in a service environment
- Healthcare Benefits/Insurance industry experience a strong plus
- Strong technology skills (Microsoft products)
- Superior, established problem-solving skills. Ability to implement solutions with little supervision in a fast paced, environment and provide supervision and mentorship to their team
- Strong verbal and written communication skills with the ability to resonate with others to impact positive outcomes
- Team player able to collaborate with other departments
Preferred experience:
- Supervisory or lead experience preferred.
- Familiarity with systems such as GBAS, Macess, RC/Max, and internal documentation platforms preferred.
What can Imagine360 offer you?
- Multiple Health plan options
- Company paid employee premiums for disability and life insurance
- Parental Leave Policy
- 20 days PTO to start / 10 Paid Holidays
- Tuition reimbursement
- 401k Company contribution
- Company paid Short & Long term Disability plus Life Insurance
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company's diversity and inclusion initiatives
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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.
Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**
Experience in benefits, claims, correspondence, member services, or healthcare operations required; proven subject matter experience in a service environment; strong technology skills with Microsoft products; strong problem-solving and communication skills; supervisory or lead experience preferred.
Key Responsibilities
- overseeing escalations
- coaching staff
- managing correspondence
Skills & Tools
Microsoft products, GBAS, Macess, RC/Max
Job Details
- Category: Customer Service
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — United States
- Salary: USD 60,000 – 68,000 / year
- Languages: English
Benefits
- 401k matching
- Generous paid time off
- Tuition reimbursement
- Retirement plan
- Generous parental leave
About Imagine360
A health plan solution company combining 50+ years of self-funding healthcare expertise to help employers save on healthcare. — Industry: Healthcare