TailorCare

Customer Support

• Assist members by monitoring patient progress through digital tracking systems and patient-reported outcomes.
• Answer non-emergent patient questions related to their MSK treatment plans and home exercise programs.
• Assist Health Coaches and Member Support with clinical questions and maintain professional scope based on licensure.
• Leverage deep knowledge of musculoskeletal anatomy, injuries, and rehabilitation to provide specialized guidance to patients and support the clinical team.
• Educate patients on their MSK diagnosis, prognosis, and treatment plan.
• Serve as a coordinator of information between patients and the clinical team, documenting all patient interactions and observations accurately within the Electronic Health Record (EHR) system.
• Provide basic technical support to patients and clinicians to resolve connectivity or platform issues and escalate to Product/Engineering

Senior Clinical Support Specialist

Call Center Representative

• Own the end-to-end design, validation, and continuous improvement of call and omnichannel routing (voice, chat, SMS, email) and queue architecture in a Salesforce + Amazon Connect environment and legacy platforms (e.g., CometChat, RingCentral), with a focus on long-term integration and platform unification.
• Diagnose and remediate agent availability and handoff problems (role boundaries, transfer logic, wrap-up states, overflow behavior) to reduce unnecessary transfers and improve first contact resolution.
• Design and implement skill-/language-based routing and load-balancing strategies to ensure equitable distribution of work across teams and bilingual agents; build sensible fallbacks for non-bilingual scenarios (interpreter/Language Line or escalation flows).
• Simplify and standardize IVR/IVR-like flows, queue definitions, and business rules to reduce complexity and operational debt while preserving necessary segmentation by program/market.
• Partner tightly with Product/Engineering, IT, and the Salesforce/Amazon Connect owners to scope, prioritize, test, and roll out routing/tool changes; translate operational requirements into engineering tickets and acceptance criteria.
• Lead and support the evaluation, implementation, and utilization of AI-driven tools to enhance agent efficiency, improve customer experience, and optimize call center performance.
• Partner with Data & Analytics to define, build, and own near-real-time and historical dashboards and reports (service level, ASA, abandonment, transfer rates, occupancy, FCR, channel deflection, interpreter usage, platform uptime/MTTR) and distribute insights to operational leaders.
• Create and maintain incident/runbook playbooks for partial/full telephony or platform outages (fallback routing, manual queueing, communications templates, stakeholder escalation matrix). Lead incident coordination during outages and run RCAs afterward.
• Establish operational thresholds and escalation triggers (e.g., service level, ASA, queue depth, interpreter wait times) and codify the actions managers should take when thresholds are breached.
• Provide staffing and forecasting inputs to Workforce Management (forecast assumptions, shrinkage, required bilingual coverage, recommended overflow pools) and ensure WFM rules align with routing logic.
• Coach and enable front-line managers: how to interpret routing/queue dashboards, enforce schedule adherence, manage handoffs, and prioritize queue clean-up or queue-specific playbooks.
• Ensure all contact center design and incident responses comply with HIPAA and any relevant security/privacy policies; partner with Compliance/Security for regular reviews.
• Drive process improvement initiatives (root cause elimination for chronic queue issues, transfer reduction, IVR deflection, automation opportunities) and lead cross-functional projects to deliver them.
• Maintain thorough documentation: routing maps, queue definitions, role handoff guides, test plans, and release notes for any configuration changes.
• Act as the operational escalation point for complex or recurring call center issues and recommend technology, process or people needs to the Sr. Director as the program scales.

Director, Contact Center

Manager

• Lead and develop a team of Clinical Navigators, including senior and lead navigators, to ensure excellence in patient engagement and outcomes.
• Foster a culture of collaboration, compassion, and accountability that aligns with TailorCare’s mission and values.
• Provide mentorship and feedback through regular coaching sessions, performance reviews, and career development plans.
• Promote shared learning, best-practice dissemination, and continuous improvement across teams.
• Oversee the daily operations of the clinical navigation program, ensuring consistent execution of TailorCare’s care model.
• Ensure compliance with clinical and operational policies, maintaining the highest standards of quality, safety, and regulatory adherence.
• Conduct clinical case reviews and support escalation pathways to ensure sound clinical decision-making and timely care coordination.
• Partner with cross-functional leaders (Training, Quality, Data, Technology, etc.) to refine workflows and elevate program efficiency.
• Use clinical and operational data to monitor individual and team performance against defined KPIs (engagement, adherence, outcomes, efficiency).
• Translate insights from data into actionable strategies that improve patient outcomes and team productivity.
• Collaborate with the Data, Analytics, and Clinical Strategy teams to identify trends, gaps, and opportunities for improvement in care delivery and engagement.
• Support development and reporting of performance dashboards, ensuring visibility of metrics at both team and leadership levels.
• Ensure that every interaction between navigators and patients is empathetic, evidence-informed, and outcomes-oriented.
• Drive initiatives to enhance engagement, retention, and patient satisfaction throughout their care journey.
• Collaborate with product and care teams to improve communication channels, digital engagement tools, and personalization of patient support.
• Advocate for the patient voice across operational and strategic discussions to continuously evolve the TailorCare experience.
• Partner with Clinical Operations leadership to align team goals with organizational strategy and growth initiatives.
• Support new market launches, scaling processes, and ensuring operational readiness of the navigation program.
• Represent the navigation team in cross-functional meetings with Product, Strategy, and Operations to influence roadmap priorities and clinical innovation.

Manager, Clinical Navigation

Clinical Operations

• Lead the Clinical Operations Platform product and define product vision and strategy
• Partner closely with Care Team to create and improve tools that deliver exceptional care to TailorCare patients
• Incorporate AI-enabled workflows to drive efficiency and optimize care delivery processes
• Work with clinicians, engineers, designers, and stakeholders to ship products that scale with business
• Set product strategy aligned with business opportunities and growth
• Ideate and own product roadmap creation, refinement, and prioritization
• Identify customer problems, ideate solutions, and collaborate with design and engineering for delivery
• Build nimble prototypes alongside stakeholders
• Be the glue across departments by earning stakeholder trust and delivering on commitments
• Accountable for product portfolio success; define and track key results and communicate progress
• Help the team think big and make good decisions quickly

Senior Product Manager, Clinical Operations

Actuary

• Serve as a senior actuarial expert, providing advanced analyses and recommendations that guide strategic decision-making across value-based care arrangements.
• Interpret and analyze data from multiple sources, including claims, provider, member, and encounters data, to identify and assess the business impact of trends.
• Anticipate and analyze industry trends, regulatory developments, and emerging methodologies, ensuring TailorCare remains competitive and prepared for market shifts.
• Lead the development and refinement of sophisticated forecasting, reserving, and pricing models, ensuring accuracy, scalability, and compliance with best practices.
• Create, enhance, and maintain advanced actuarial models that project MSK utilization, establish cost benchmarks, and quantify TailorCare’s cost savings.
• Integrate predictive analytics and, where appropriate, machine learning into model design to improve forecasting precision and risk assessment.
• Continuously monitor model performance, identifying and implementing enhancements to meet evolving client, regulatory, and internal requirements.
• Evaluate and provide actuarial recommendations on new and existing risk-based contracts, focusing on financial sustainability and performance optimization.
• Design and maintain risk mitigation strategies, including reserving, stop-loss, reinsurance, and contract-based mechanisms.
• Analyze contract performance and utilization trends, delivering actionable insights to improve outcomes and cost efficiency.
• Partner closely with finance, analytics, and operational teams to ensure alignment between actuarial insights and enterprise objectives.
• Mentor and provide technical review for actuarial associates and analysts, enhancing team capability and accuracy.
• Present complex analyses and recommendations to senior leadership with clarity and strategic relevance via monthly MLR reviews, quarterly financial reviews, etc.
• Develop and maintain rigorous standards for actuarial analysis, ensuring consistency, reliability, and transparency across all deliverables.
• Champion data integrity, collaborating with analytics teams to ensure accuracy and completeness of all actuarial data sources.
• Report on national, market, and deal-specific trends, translating findings into actionable recommendations.

Senior Managing Actuary

Project Manager

• TailorCare is transforming the experience of specialty care, improving outcomes for joint, back, and muscle conditions through evidence-based, personalized care.
• Lead and manage end-to-end project lifecycles, ensuring alignment with organizational strategy and enterprise goals
• Support the successful implementation of new partnerships by managing timelines, deliverables, and cross-functional coordination
• Partner closely with internal stakeholders and external partners to ensure clear communication, expectations management, and timely issue resolution
• Collaborate with internal stakeholders to define project scope, goals, timelines, and deliverables
• Track and manage project milestones, scope, performance metrics, and budgets across enterprise-level initiatives
• Identify and mitigate risks and roadblocks to ensure timely execution
• Contribute to the continuous improvement of project planning tools, templates, dashboards, and reporting mechanisms
• Collaborate with senior leadership to align project execution with strategic business objectives
• Facilitate project planning sessions, retrospectives, and status meetings with internal and external stakeholders
• Support change management initiatives and process improvement efforts by identifying inefficiencies and implementing data-driven, scalable solutions

Project Manager, Performance Excellence

• TailorCare is transforming the experience of specialty care by improving patient outcomes for joint, back, and muscle conditions.
• Lead and grow product organization, hiring, guiding, coaching, and developing product talent.
• Establish and amplify product culture focused on customer problems, incremental delivery, and continuous iteration.
• Define product lines and areas of ownership for product managers and empower strategic vision.
• Communicate progress, resolve dependencies, celebrate wins, and collaborate closely with engineering.
• Guide product and technical teams to move quickly and deliver high quality solutions including patient data management, patient engagement channels, and ML-aided clinical decision support.
• Serve as thought partner with VP of Product to set product vision and make long-term bets.
• High growth potential for personal development and building a strong organization from the ground up.