Senior Manager, Member Services

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

📋 Description

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

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

• Evaluate contact center KPIs to detect trends, address performance deficiencies, and continuously enhance member engagement results.

• Develop and uphold a QA framework that guarantees consistent call quality, compliance with HIPAA, and documentation that is ready for audits.

• Propel measurable outcomes towards value-based care objectives: closing care gaps, conducting Annual Wellness Visits, performing Health Risk Assessments, measuring HEDIS, administering Patient Reported Assessments, and driving SDOH initiatives.

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

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

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

• Oversee staffing models, schedule allocations, and distribute workloads among the team.

• Create and implement training programs that enhance frontline capabilities and ensure the team is prepared for evolving program demands.

• Foster a performance-driven culture with clear objectives, regular assessments, and visible career advancement opportunities for frontline staff.

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

• Work across departments to accommodate new client requirements and align Member Services with broader organizational objectives.

⛳️ Requirements

• A minimum of 7 years of progressive leadership experience in healthcare or managed care operations, including significant management of a contact center or outreach function at scale.

• Practical experience with Five9 or a comparable contact center platform, encompassing campaign management, queue oversight, and workforce reporting.

• Proven track record of leading large frontline teams within a healthcare or managed care setting.

• Understanding of value-based care metrics such as care gap closures, HEDIS, SDOH, HRA, AWV, and associated 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 regulations 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.

🏝️ Benefits

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

• Annual incentive bonus of up to 5.75%

• Comprehensive medical, dental, and vision insurance

• 401(k) retirement plan

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

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

• The opportunity to make a significant impact — and witness the direct effects of your work on communities nationwide