Escalations Specialist

One Pass is redefining how people engage with health, wellness, and everyday living. Through a comprehensive engagement and loyalty platform, we empower millions of members to live healthier, more connected lives. Backed by deep partnerships across healthcare and supported by a culture of innovation, cross‑functional collaboration, and relentless curiosity, One Pass is scaling rapidly and shaping the future how people lead healthier, fuller lives.

The Escalations Specialist will be responsible for managing and resolving complex member cases and escalations, ensuring that our members have a seamless and positive experience with our services. You will work closely with our customer service team, other departments, partners, and management to handle high‑priority or difficult issues, resolve conflicts, and ensure high levels of member satisfaction. You will also serve as the team’s subject matter expert on refund‑related escalations, applying refund policies and procedures consistently, monitoring refund trends, and supporting refund reporting and analysis.

Your goal will be to provide effective solutions, mitigate member dissatisfaction, maintain the integrity of our brand, and identify opportunities to improve the overall member experience.

• Manage and resolve escalated member cases, including partnership/network access, technology issues, refund-related concerns, and other high‑priority or complex member issues.

• Investigate and analyze the root causes of escalated issues, providing tailored solutions to ensure member satisfaction and loyalty.

• Collaborate with other teams and external vendors/partners to resolve issues and improve member experiences.

• Serve as the team’s subject matter expert for refund policy, applying established guidelines consistently across member cases, making recommendations in accordance with established policies and business guidelines.

• Review and investigate complex refund requests and exception cases, making recommendations in accordance with established policies and business guidelines.

• Conduct audits of refund cases and refund‑related processes to ensure accuracy, policy compliance, consistency, and adherence to operational standards.

• Monitor, analyze, and report on refund trends, approvals, denials, and exception requests, flagging opportunities for process.

• Share insights and trends from escalated cases and refund analyses with relevant teams to drive continuous improvement and prevent recurring issues.

• Identify opportunities to streamline processes and improve case resolution times.

• Contribute to the development and maintenance of best practices, guidelines, and documentation for handling complex member cases and refund‑related processes.

You’re a proactive problem-solver who thrives under pressure and knows how to balance urgency with judgment. You bring strong customer service instincts, sharp time management, and the ability to prioritize competing escalations without losing sight of the member experience. You know when a case is yours to resolve and when it needs to go to internal management — and you make that call quickly and confidently.

You communicate clearly in writing, are comfortable working across digital tools (including AI‑assisted tools to draft and refine member communications), and you don’t wait to be told there’s a problem — you spot it and raise it.

• 3+ years in escalations management, customer service, or a related role.

• Proven experience managing complex cases and delivering resolutions in a timely and empathetic manner.

• Demonstrated experience using CRM systems, with Salesforce strongly preferred. Must be proficient in managing…