Own end-to-end CTM and Grievance performance — KPIs, compliance, QA strategy, and execution across the full ecosystem
Lead complex problem solving, using data and structured thinking to identify root causes and build scalable, enterprise-level solutions
Drive adoption of new tools and ways of working — including AI-enabled workflows — across teams that may be skeptical or stretched
Translate complaint, audit, and operational data into insights that drive upstream improvements and reduce risk before it reaches CMS
Build and standardize operating models, processes, and reporting that enable consistent, scalable, and audit-ready execution
Partner cross-functionally with Product, Engineering, Clinical, and Operations to influence benefit design, claims processes, and member experience based on what the complaint data is telling us
Lead large-scale operations while driving transformation — balancing near-term execution with longer-term process and technology improvements
Develop and coach leaders, building capability, accountability, and organizational strength in a fast-moving environment
Lead resource and capacity strategy, including budgeting and technology investments to improve efficiency and outcomes

Bachelor’s degree or 7+ years of experience in healthcare, operations management, or a related field.
Proven ability to lead large, complex operations and deliver measurable performance outcomes.
Experience building leaders and aligning diverse stakeholders to set direction in dynamic environments.
Ability to turn ambiguous data into structure and clear, actionable plans.
Early adopter of AI and automation tools with experience building, using, or partnering to deploy solutions that improve speed and accuracy in regulated settings.
Supporting or responding to regulatory audits — CMS experience a plus
Complaint resolution, grievance workflows, or service operations
Leading operational transformations — process redesign, technology adoption, or workflow automation.

Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
Parental leave program
401K program
And more....

Senior Manager – Grievances, Medicare Complaints

Key skills