Resolution Response Specialist

Maven Clinic is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Through Maven Enterprise, the company partners with more than 2,300 employers and health plans to provide end-to-end women's and family health programs spanning fertility and family building, maternity and newborn care, parenting and pediatrics, and menopause and midlife — improving clinical outcomes, reducing healthcare costs, and expanding equitable access to high-quality care at scale. Through its consumer platform, Maven provides direct access to virtual care across 30+ specialties, as well as dedicated hormone and GLP-1 care programs purpose-built for women. Founded in 2014 by CEO Kate Ryder, Maven Clinic has raised more than $425 million from leading healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. Recognized for innovation and industry leadership, Maven has been named to the TIME100 Most Influential Companies, CNBC Disruptor 50, Fast Company's Most Innovative Companies, and FORTUNE Best Places to Work. Learn more at mavenclinic.com An award-winning culture working towards an important mission – Maven Clinic is a recipient of over 30 workplace and innovation awards, including: • TIME 100 Most Influential Companies (2023, 2026) • Fortune Change the World (2024) • CNBC Disruptor 50 List (2022, 2023, 2024) • Fortune Best Workplaces for Millennials (2024) • Fortune Best Workplaces in Health Care (2024) • Fast Company Most Innovative Companies (2020, 2023) • Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024) About the Role: Maven is looking for a Resolution Response Specialist 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 improvem