Customer Success Lead

Overview

Alignment Health is committed to serving seniors and the chronically ill. We build a passionate, caring team focused on putting the senior first and delivering high‑quality, low‑cost care every day.

• Take full ownership of complex, urgent, and high‑visibility member escalations including executive and market‑leader cases.
• Lead service recovery with empathy, active listening, and trust restoration.
• Serve as the primary point of contact from intake through resolution, ensuring accuracy, compliance, and alignment with organizational tone.
• Partner cross‑functionally to remove barriers and drive resolution for escalations requiring coordination across departments.

• Maintain a “working” role by handling inbound and outbound member interactions in line with productivity and service‑level goals.
• Support daily triage, prioritization, and timely follow‑up of escalation cases.
• Monitor active cases to ensure adherence to SLAs, quality standards, and service recovery expectations.
• Address complaints and grievances in accordance with Medicare Managed Care requirements and internal procedures.

• Act as a subject‑matter expert and primary resource for specialists with real‑time guidance, coaching, and escalation support.
• Assist with onboarding, nesting support, live call monitoring, and guidance to ensure readiness and confidence.
• Foster a culture of empathy, accountability, and high standards of member care.

• Monitor individual and team performance across productivity, quality, and service metrics.
• Identify trends in escalations and member feedback; provide insights and recommendations to leadership.
• Partner with training and leadership to identify skill gaps and support ongoing development initiatives.
• Contribute to process improvement efforts aimed at reducing escalations, increasing efficiencies, and improving the overall member experience.

• Collaborate closely with the Supervisor, Customer Success to align priorities, escalations, and team performance.
• Maintain clear, professional, and effective communication with internal stakeholders, including leadership and cross‑functional partners.
• Support reporting needs related to escalation trends, risks, and service recovery outcomes.

• Maintain strict adherence to HIPAA, privacy, and data security standards.
• Ensure all member interactions and case documentation meet regulatory and organizational compliance requirements.

• Assist with monitoring attendance and schedule adherence.
• Encourage a culture of accountability, collaboration, and continuous improvement.
• Perform other duties as assigned and support the Supervisor, Customer Success in day‑to‑day oversight.

• Strong knowledge of Medicare Managed Care plans required.
• 3+ years of customer service experience required (healthcare preferred).
• Previous lead or equivalent experience required.
• Experience handling complex or executive‑level escalations strongly preferred.
• Bilingual (English/Spanish) preferred.

• High school diploma or GED with relevant work experience required.
• Bachelor’s degree in Healthcare Administration, Business, or related field with relevant work experience preferred.

• No training required.

• Working knowledge of Microsoft Excel, PowerPoint, SharePoint, and Power BI.
• Experience with Microsoft Teams and case management systems.
• Strong communication skills with the ability to bridge people, process, and technology.
• Demonstrated ability to handle high‑pressure situations with professionalism and sound judgment.
• Strong ownership mindset and accountability.
• Empathy and emotional intelligence in high‑stress interactions.
• Conflict resolution and de‑escalation expertise.
• Critical thinking and problem‑solving skills.
• Ability to influence and support peers without direct authority.

• No license required.

• Regularly required to sit; use hands to finger, handle, or feel and talk or hear.
• Frequently required to…