Senior Manager, Member Services

This is a fully remote position, open to applicants in Texas.

📋 Description

• Take charge of the daily performance of the outreach center, managing inbound and outbound calls, executing campaigns, scheduling, workforce management, and real-time quality monitoring.

• Oversee and enhance calling campaigns using Five9 or a similar platform, including managing call routing, queue management, and agent productivity.

• Examine contact center KPIs to spot trends, tackle performance gaps, and continually enhance member engagement results.

• Develop and maintain a Quality Assurance framework that guarantees consistent call quality, adherence to HIPAA regulations, and documentation that is audit-ready.

• Propel measurable outcomes aligned with value-based care objectives: closing care gaps, conducting Annual Wellness Visits, performing Health Risk Assessments, achieving HEDIS measures, collecting Patient Reported Assessments, and implementing SDOH initiatives.

• Assess the effects of quality and risk adjustment activities; formulate corrective action plans when performance trends suggest potential risks.

• Monitor and report KPIs related to outreach effectiveness, completion of care gaps, and value generation; present findings to senior leadership.

• Supervise Team Leads as direct reports, establishing performance expectations, providing coaching, and ensuring accountability for frontline outcomes.

• Administer staffing models, scheduling, and workload distribution among the team.

• Create and deliver training programs that enhance frontline capabilities and ensure the team is prepared to meet changing program requirements.

• Foster a performance-oriented culture with clearly defined goals, regular assessments, and visible career advancement opportunities for frontline staff.

• Collaborate with Technology, Product, Data, and Finance teams to enhance dashboards, automation, and reporting functionalities.

• Work together with various departments to address new client needs and align Member Services with the wider organizational objectives.

⛳️ Requirements

• 7+ years of progressive leadership experience in healthcare or managed care operations, with significant experience managing a contact center or outreach function at scale.

• Hands-on experience with Five9 or a comparable contact center platform, encompassing campaign management, queue monitoring, and workforce reporting.

• Proven experience leading large frontline teams in a healthcare or managed care setting.

• Understanding of value-based care metrics, including care gap closures, HEDIS, SDOH, HRA, AWV, and related quality programs.

• Strong analytical abilities and comfort in making data-driven decisions in a dynamic environment.

• Exceptional communication and interpersonal skills — capable of leading across various levels and collaborating effectively with cross-functional teams.

• Knowledge of HIPAA and relevant healthcare compliance standards.

• Bachelor’s degree in Business Administration, Healthcare Management, or a related field; a Master’s degree is a plus.

• Proficient in Google Workspace.

• Clinical background or experience in a health plan or value-based care environment (preferred).

• Experience with Salesforce and Tableau (preferred).

🏝️ Benefits

• Competitive salary range of $90,000–$115,000

• Annual incentive bonus up to 5.75%

• Comprehensive medical, dental, and vision coverage

• 401(k) plan

• Generous paid time off, including your birthday off, 9 company holidays, and a PTO accrual that increases with tenure

• Remote-first culture with occasional travel to our growth markets

• The opportunity to create something meaningful and witness the direct impact of your work on communities nationwide