Supervisor, Member Escalations & Correspondence

Imagine
360 is seeking a Supervisor, Member Escalations & Benefits Correspondence 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, including benefits, claims status, eligibility, predeterminations, and other benefit-related requests. This role ensures timely, accurate, high-quality, and compliant responses to escalated call situations and benefits correspondence while maintaining white-glove service, expedient turnaround standards, and an effortless member and provider experience.

The Supervisor provides daily guidance, coaching, quality oversight, workflow coordination, and operational support to ensure team efficiency, accuracy, and adherence to organizational service expectations. This position requires exceptional communication, proven leadership experience, strong problem-solving skills, and the ability to calmly navigate high-visibility escalations while supporting team members in a fast-paced, dynamic environment.

• Provide day-to-day coaching, support, supervision, and development to staff handling escalations and benefits correspondence.
• Conduct regular performance evaluations and monitor quality, productivity, utilization, schedule adherence, and performance goals.
• Deliver corrective action when appropriate, including coaching, documentation, and follow-up.
• Lead monthly team meetings, 1:1s, and ongoing development conversations that support performance and build bench strength within the team.
• Serve as the primary point of contact for questions, escalation assistance, and process clarification.
• Support change management efforts while promoting a positive, supportive, service-focused culture.

• Manage escalated or sensitive member issues requiring advanced intervention beyond frontline agents.
• Review, triage, and prioritize escalations to determine next steps, ensuring urgent and non-urgent criteria and response expectations are met.
• Lead staff responsible for written inquiries regarding benefits, claims status, eligibility, predeterminations, and other benefit-related requests.
• Ensure outgoing correspondence meets quality, accuracy, compliance, production, and turnaround standards.
• Support staff in resolving complex benefit inquiries requiring research, judgment, or collaboration across departments.
• Provide wrap-up communication to leadership as appropriate for high-visibility cases.

• Distribute and monitor daily workloads to ensure appropriate coverage across correspondence and escalations.
• Coordinate incoming work queues and ensure efficiency across functions.
• Track team productivity, quality, schedule adherence, email quality, production goals, and turnaround times.
• Review quality audits, provide targeted coaching, and guide staff toward performance improvements.

• Partner with internal teams, including Client Experience, Medical Management, Provider Services, Correspondence, Member Services, Clinical teams, and other stakeholders to support resolution of escalations and high-impact issues.
• Act as liaison across departments to support timely resolution and consistent communication.
• Communicate trends, issues, and updates to leadership and recommend action steps.
• Identify opportunities to streamline processes, improve efficiency, and enhance the member experience.
• Partner with leadership on new system or process implementations impacting escalations or correspondence.
• Ensure SOPs, training materials, and…