The CARE Lead Specialist helps define, build, test, deploy, and sustain CARE roles, workflows, and operating routines. The role serves as a subject matter resource for CARE Specialists and operational leaders by translating business needs into clear, scalable processes and supporting testing, training, deployment, and ongoing updates in partnership with Operations, Learning and Development, Quality, Workforce Management, Product, Engineering, and other business partners.Purpose:The CARE function proactively identifies and addresses customer situations that could result in first call resolution failure, repeat contacts, escalations, or negative customer experiences. The objective is to improve the customer journey and operational efficiency through early intervention, outbound customer contact, and timely case resolution. CARE Specialists work assigned outbound cases and support strategic initiatives including PolyAI testing, end-to-end user acceptance testing, and other business-critical projects.Context:The CARE foundation is modeled after the EU Outbound approach, which has delivered reductions in inbound call volume and cost per claim. As the Digital First strategy expands into North America, CARE supports customers who do not opt into digital experiences, prefer not to file online, or need additional assistance navigating available options while supporting broader efficiency and cost-reduction objectives. How Success Is Measured:Program-level impact: Reduce contacts per claim, inbound voice volume, claim duration, and cases outside SLA through proactive outreach and case management.Customer experience: Improve CSAT and NPS by preventing negative experiences and resolving stalled or high-risk claims before escalation.Operational efficiency: Support hotline reduction, improve case completion, reduce repeat contacts, and improve first call or specialist case resolution.Quality and accuracy: Maintain strong QA performance, accurate case notes, appropriate resolutions, and adherence to follow-up timelines.Risk prioritization: Focus on high-severity and high-frequency drivers, including claims stalled during payout, replacement, repair, intervention screens, and preapproval troubleshooting. Assess account risk based on factors including longevity, number of PPs, previous escalations, previous poor expectations, or a high-touch partner.Key Duties and Responsibilities:Develop, refine, and maintain CARE role responsibilities, operating routines, workflows, decision points, documentation, and support expectations.Support the creation, review, and testing of CARE functions, including case identification, queue monitoring, outbound follow-up, SLA risk review, resolution paths, and escalation prevention.Participate in user acceptance testing, pilots, test case development, defect identification, and process validation for systems, dashboards, AI-supported workflows, and operational changes.Provide structured feedback to leadership and cross-functional partners on system gaps, workflow issues, customer friction, specialist readiness, and improvement opportunities.Support deployment and post-launch stabilization, including readiness criteria, training and communication needs, issue identification, performance monitoring, and continuous improvement.Partner with Learning and Development and operational leaders on training, job aids, knowledge updates, nesting, and ongoing support for CARE Specialists.Ensure CARE processes are applied consistently while supporting partner-specific, customer-specific, or risk-based handling needs.Reinforce expectations for ethical conduct, customer focus, data protection, accurate documentation, and responsible use of tools, systems, and AI-supported processes.Support leaders with insights on process adoption, recurring defects, customer friction, and opportunities to improve FCR, SCR, CSAT, NPS, claim duration, and cost per claim.
