Customer Advocacy Team Lead

We are looking for an experienced Customer Advocacy Team Lead to guide the resolution of complex customer concerns in a highly regulated environment. This position oversees sensitive case handling, supports service quality and compliance standards, and works closely with cross-functional partners to drive timely, accurate outcomes. The ideal candidate brings strong leadership, sound judgment, and a customer-centered approach to escalated issue management.

Responsibilities:
• Direct the day-to-day coordination of escalated customer matters, including complaints, appeals, grievances, and executive-level concerns.
• Distribute assignments across the team, monitor service timelines, and address risks that could affect resolution quality or turnaround expectations.
• Evaluate case findings, correspondence, and supporting records to ensure responses are accurate, complete, thorough, and aligned with policy requirements.
• Provide hands-on guidance to team members by strengthening investigative methods, written communication, documentation practices, and decision-making consistency.
• Collaborate with departments such as compliance, legal, billing, claims, enrollment, and operations to remove barriers and support effective case resolution.
• Maintain organized tracking tools, documentation templates, and case records to support visibility, consistency, and operational control.
• Analyze recurring complaint patterns and workflow gaps, then recommend practical improvements to enhance service delivery and reduce repeat issues.
• Contribute to audit preparation, reporting activities, and ongoing quality initiatives by ensuring documentation is complete and review-ready.
• Promote strong privacy, compliance, and recordkeeping standards while modeling accountability, service excellence, and customer advocacy in every interaction.

• At least 5 years of experience in healthcare, health insurance, regulatory support, escalated customer service, appeals, grievances, or a similarly structured environment.

• A minimum of 2 years in a lead, senior-level, coaching, or workflow oversight capacity.

• Strong ability to write clearly, investigate issues thoroughly, and maintain detailed, accurate documentation.

• Demonstrated success handling time-sensitive cases, competing priorities, and high-impact customer concerns.

• Experience coaching colleagues and driving consistency across complex operational processes.

• High school diploma or equivalent is required.

• An associate or bachelor’s degree is preferred.

• Background in complaint resolution, audit support, reporting, or compliance review activities is advantageous.