Service Operations Manager

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.
Join us in improving health care outcomes for all!  We promise to do what’s right, always.

Position Summary:
The Service Operations Manager oversees claims processing and contact center vendors, ensuring seamless service delivery and strong vendor performance. This role manages SLAs, escalations, and reporting, supporting Client Management and Member Experience teams while aligning processes with client expectations and regulatory standards.

What you will do:

Vendor Relationship Management:
•    Serve as the day-to-day point of contact for claims processing and contact center vendors, fostering strong working relationships to ensure smooth operations and service delivery
•    Manage day-to-day vendor interactions, addressing any challenges, concerns, or questions that may arise and ensuring that issues are resolved promptly
•    Coordinate with internal teams to communicate vendor capabilities, limitations, and updates, aligning vendor performance with client needs and expectations

Performance Monitoring and Escalations:
•    Track and monitor vendor performance guarantees, including claims processing turnaround times, call center response times, and other key performance indicators (KPIs) to ensure SLA adherence
•    Identify and escalate issues, performance deviations, and service disruptions, managing the resolution process to ensure timely and effective outcomes
•    Collaborate with the vendor and internal teams to implement corrective actions when performance does not meet agreed-upon standards

Reporting and Analytics Support: 
•    Provide reporting and analytical support to the Client Management team, ensuring that data related to vendor performance, claims processing, and contact center activities is captured, analyzed, and delivered in a timely manner
•    Develop and maintain regular performance dashboards and reports to keep internal stakeholders informed of vendor performance, trends, and any emerging issues
•    Utilize reporting tools to identify opportunities for operational improvements and service delivery enhancements

Process Optimization and Continuous Improvement:
•    Collaborate with both vendors and internal teams to identify and implement process improvements aimed at enhancing the efficiency, quality, and accuracy of claims processing and contact center operations
•    Monitor ongoing service delivery and propose strategies to optimize workflows, reduce errors, and improve the overall member experience
•    Ensure that the vendor's services are compliant with all regulatory and contractual requirements

Cross-Functional Collaboration: 
•    Work closely with internal teams, including Client Management and Member Experience, to ensure seamless communication and integration between vendors and internal systems or processes
•    Act as a liaison between internal stakeholders and vendors to ensure alignment on expectations, timelines, and key deliverables
•    Provide support for any client-facing meetings or discussions related to vendor performance, issues, or ongoing improvements

What you need:
•    Bachelor’s degree in Business Administration, Healthcare Administration, or a related field
•    PMP or Six Sigma certification is a plus but not required
•    5+ years of experience in vendor management, operations, or service delivery management, preferably in the pharmacy benefit management (PBM) or healthcare industry
•    Strong background in managing vendor relationships, including claims processing or contact center operations
•    Proven experience with performance tracking, escalation management, and reporting in a fast-paced environment
•    Strong communication and interpersonal skills, with the ability to manage and negotiate vendor relationships effectively
•    Excellent problem-solving skills, with the ability to handle escalations and resolve issues promptly
•    Strong attention to detail, with the ability to analyze data, generate reports, and provide actionable insights
•    Ability to work collaboratively across multiple departments to align vendor services with organizational goals
•    Proficient in project management and reporting tools, with an understanding of performance tracking systems
•    Familiarity with claims processing systems, contact center technologies, and PBM operations
•    Experience working with SLAs and performance guarantees in a vendor management context

What you get:
•    To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes
•    To work in a culture where people thrive because when OUR team thrives, OUR business thrives
•    Competitive compensation, including health, dental, vision and other benefits

Note:  
AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.