Manager, Member Services

Title: Manager, Member Services

Department: USFHP Member Services

Reports To: Chief Operating Officer

Location: Manhattan, NY – HYBRID

Education: Bachelors (BA/BS) – Required

Job Type: Full Time, Exempt

Job Summary

The Manager of Member Services is a key member of the management team whose primary concern is facilitating optimal organizational performance for the Member Services Department. Reporting directly to the COO, the Manager’s primary responsibility is to oversee daily operations, ensuring the department works seamlessly to achieve organizational objectives. The Manager drives process improvements, optimizes resource allocation, and fosters a culture of operational excellence.

Responsibilities

• Manage the day-to-day operations of the Member Services Department, directly or through delegated authority to department supervisors.
• Lead the development of the operational components of the Member Services Department to ensure alignment with the health plan’s strategic plan; review activities, set direction, strategize around opportunities and threats, and review goals, objectives, and outcomes on an ongoing basis.
• Identify learning needs and advocate for training and technical support to properly implement departmental policies and procedures; continually educate and empower department supervisors/managers to inform, train and support all staff members.
• Ensure the development, integration, effective management, and sustainability of accurate and efficient systems, and policies and procedures for the departments’ operational functions.
• Plan, organize, and evaluate various projects, programs and services involving department operations; oversee or manage specific projects, programs, and services as required.
• Collaborate with executive leadership to identify ways to support the health plan’s mission, vision, values, and goals through effective talent management, including recruiting, hiring and retention strategies, succession planning, career laddering, onboarding, training, professional development, and performance assessment and recognition.
• Establish, maintain, and evaluate departmental readiness including the maintenance of accurate and efficient operations; cultivate mutually beneficial partnerships with vendors and other business partners; maintain current knowledge of the healthcare industry and TRICARE policies.
• Ensure department performance meets/exceeds organizational goals and TRICARE standards.
• Design and implement policies, procedures, and systems to manage, measure, analyze and improve departmental performance via quality improvement, resulting in measurable high-quality service delivery, increased operational efficiency and cost-effectiveness, and improvements in beneficiary satisfaction and health plan recognition.
• Facilitate the development of knowledge, attitudes, skills, and behaviors necessary for team members to function together with a high degree of engagement and satisfaction, attaining the highest possible levels of effective performance.
• In collaboration with the IT department, participate in the evaluation, selection, and implementation of technology and software that will optimize the member and employee experience, and facilitate the integration of technology to optimize department operations.
• Demonstrate clear, effective, and efficient communications, including the use of effective listening skills and constructive feedback; prepare reports and documents and utilize communication strategies to promote stakeholder understanding; plan and conduct impactful and productive business meetings.
• Conduct or participate in focused internal audits of department policy and procedure adherence as well as coordinating audits generated by external sources, such as The Defense Health Agency, URAC, or other regulatory bodies.
• Demonstrate commitment to the highest standards of ethical responsibility, credibility, objectivity, accountability, and trustworthiness.
• Other responsibilities as assigned

Competencies

• Strong advocate for policy development, improvement, and compliance that ensures personal accountability throughout the managed departments. Able to discuss, incorporate, and apply effective management techniques and theories in leadership activities.
• Ability to serve as a subject matter expert, technical expert, and thought leader on issues and provide guidance, develop solutions for both predictable and unpredictable events or circumstances, and develop others/teams.
• Able to proactively engage with direct and indirect reports, provide guidance, set expectations for meeting goals and priorities, and develop corrective action plans when goals are not met.
• Ability to identify mission-centric opportunities for stakeholder engagement, community outreach, and managed departments while ensuring process focus on strategic business drivers including growth, service, quality, people, financial health, and key internal and external relationships.
• Able to develop and communicate a clear vision and strategy for managed departments that aligns with the health plan’s goals and objectives, and can anticipate and respond effectively to changes in the external environment.
• Ability to forecast staffing requirements and patterns to support strategic growth or shifts in health plan personnel availability. Able to ensure staffing requirements and patterns meet health plan regulatory/accreditation/compliance requirements.
• Ability to set a consistent and strong example for upholding fair and honest ethical and moral standards. Be an advocate for ideas based on facts and experience.
• Proactively and continually assess personal strengths and challenges and manage learning and guidance needs.

Supervises the Following Department or Program Leaders

• (1 FTE) Direct report; Member Services Supervisor

Experience

• At least five (5) years managing or supervising a customer service or call center department in a health plan or managed care setting.
• Proven ability to manage multiple projects and priorities simultaneously.
• Previous experience with development and implementation of health care organizational policies and procedures.
• Proven problem solving, program-development, team-building and training skills required.

Education/Background Check

• Bachelor’s degree, healthcare management preferred, or equivalent experience
• Masters in Health Care Administration preferred

SALARY RANGE: $100,000.00 – $105,000.00

SVCMC IS AN EQUAL OPPORTUNITY EMPLOYER – ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO PROTECTED VETERAN STATUS, DISABILITY, OR OTHER CHARACTERISTICS PROTECTED BY LAW.