AVP, Member Experience

Job title: AVP, Member Experience

Position Summary:

This role leads the enterprise-wide definition, communication, implementation, and maintenance of stakeholder experiences and journeys, with a strong focus on Member and Provider engagement. The position collaborates with cross-functional leaders to design and measure outcomes that improve satisfaction and quality performance. A key responsibility is to drive the implementation of new technical and AI capabilities in collaboration with the Technology team to enhance member experiences and quality results.

The leader will work closely with teams across experience quality, training, knowledge management, and customer service to ensure consistent adoption and staff proficiency in delivering positive experiences. The role is also accountable for managing administrative financial targets and designing integrated programs that improve overall stakeholder satisfaction and brand affinity.

Key Responsibilities:

• Define and deliver holistic member and provider journeys across digital, print, and voice channels.
• Assess current vs future state experiences and create actionable roadmaps for improvement.
• Execute new capabilities and tools, supported by data-driven quality, training, and hiring Utilize platforms such as Genesys, Salesforce (Service, Marketing, Experience, and Health Clouds), Adobe Experience Manager, and Consumer Data Platforms to create seamless experiences.
• Serve as a product owner, planning development and prioritizing feature functionality.
• Partner with clinical leadership to enhance operations and improve metrics such as Net Promoter Score (NPS), CAHPS, Medicare Stars, and member retention.
• Break down complex initiatives into deliverable parts that create incremental value.
• Architect and implement experiences using multidisciplinary teams and community-based assets.
• Create and execute cost containment and stakeholder value retention strategies.
• Improve engagement through deeper integration with community resources and understanding local population needs.
• Manage retail and community-based staff to meet performance KPIs.
• Lead through collaboration and accountability, aligning stakeholders and executing projects effectively.
• Manage diverse and remote teams across various locations and functions.

Qualifications:

• Bachelor’s degree in a healthcare, clinical, business, or related field; Master’s preferred.
• 12–15+ years of experience in stakeholder experience and managed healthcare.
• Strong leadership in enterprise-wide initiatives, metric development, performance improvement, and cost containment.
• Experience working with complex technical platforms (Genesys, Salesforce, AEM).
• Knowledge of insurance operations, including customer service, billing, medical management, and claims.
• Strong regulatory awareness and the ability to interface with state and federal regulators.
• Excellent communication and cross-functional collaboration skills.

 We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws