[Hiring] Senior Associate, Resolution Response Team @Maven Clinic

Role Description

Maven is looking for a Senior Associate, Resolution Response Team who will lead the end-to-end resolution of complex, high-risk member escalations, serving as a Tier 2 senior owner within the Resolution Response Team to ensure every escalation is handled consistently, efficiently, and at the right level the first time — restoring member trust while protecting Maven, its clients, and its members.

This is a non-exempt, Monday–Friday position with hours of 8:30 a.m.–5:00 p.m. ET and occasional weekend coverage as needed.

What You’ll Do:

• Own escalated member cases end-to-end, serving as the single accountable owner for moderate-to-high complexity issues across billing, reimbursement, benefits, coordination of benefits, network exceptions, and service breakdowns.
• Conduct structured investigations using the established triage framework (Category → Owner → Macro → Checklist → SLA → Escalation Path), reviewing ticket history, call recordings, prior guidance, client documentation, spend, and reimbursement records before resolution.
• Lead service recovery by reviewing low-rated interactions, conducting proactive outreach (call-first where possible), applying de-escalation protocols, and confirming closed-loop resolution with a written member recap.
• Serve as the primary cross-functional bridge across MBS, Support, Care Delivery, Client Success, Payment Operations, Network Operations, Product, Engineering, and Legal/Compliance to coordinate corrective action and accelerate resolution.
• Communicate with members using approved macros and empathy-led, legally protective language; provide CSMs with concise case summaries and polished client-facing messaging when needed.
• Identify and route risk using Critical/High/Standard severity and SEV 2/SEV 3 legal protocols for legal, compliance, discrimination, or regulatory exposure.
• Maintain precise documentation in Zendesk and the escalation tracker, applying granular themes, reason codes, and ownership tags to enable reliable root-cause reporting.
• Identify escalation trends and drive macro, playbook, and process improvements that reduce recurrence and prevent repeat escalations.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Communications, or related field preferred, or equivalent experience.
• 3+ years in escalation management, member/customer advocacy, health benefits, or healthcare operations.
• Experience resolving complex, multi-stakeholder escalations; strong knowledge of employer-sponsored benefits, reimbursement and claims workflows, and the fertility/family-building member journey.
• Familiarity with Zendesk, Jira, Guru, Google Sheets, and Looker.
• Highly organized and detail-oriented, with strong critical thinking, root-cause analysis, and structured case management skills.
• Excellent verbal and written communication, with strong de-escalation skills and the ability to translate complex benefits and billing issues into clear resolution plans.
• Sound legal and risk judgment, with the ability to identify when to involve Legal, Compliance, or leadership and collaborate effectively across teams.
• Empathetic, composed, and member-centric, with the ability to navigate high-emotion, high-stakes cases through resolution.
• Resourceful, solutions-oriented, and comfortable with shifting priorities; motivated to improve processes, build scalable playbooks, and prevent repeat escalations.

Requirements

• The base salary range for this role is $82,000 - $96,000 per year.
• This role requires active work authorization in the US.
• Maven embraces a flexible and inclusive work environment.
• This role is open to candidates in: AZ, DC, DE, FL, GA, HI, IL, KS, MA, MD, ME, MI, MN, MO, NC, NJ, NM, NV, NY, OH, OR, PA, SC, TN, TX, VA, VT, WI.

Benefits

• Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning, and pediatrics.
• Whole-self care through wellness partnerships.
• Hybrid work, in-office meals, and work together days.
• 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+).
• Annual professional development stipend and access to a personal career coach through Maven for Mavens.
• 401K matching for US-based employees, with immediate vesting.