Senior Manager, Member Services and Enrollment

Department:  Member Services and Enrollment

Reports To: Chief Operating Officer

Location: Manhattan, NY – HYBRID

Education: Bachelor’s Degree Required

Job Type: Full Time, Exempt

Job Summary

The Senior Manager of Member Services and Enrollment is a key member of the management team whose primary
concern is facilitating optimal organizational performance for the Member Services and Enrollment Departments.
Reporting directly to the COO, the Senior Manager’s primary responsibility is to oversee daily operations, ensuring
both departments work seamlessly to achieve organizational objectives. The Senior 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 and Enrollment Departments, directly or through delegated authority to department supervisors.
• Lead the development of the operational components of the Member Services and Enrollment Departments 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.

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

• Member Services (2 FTEs); Enrollment (1 FTE)

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
• ADP II security clearance required (United States government-designated level of clearance). Employee must successfully obtain ADP II security clearance. Employment will be terminated if employee does not obtain ADP II security clearance.

SALARY RANGE: $110,000.00 – $115,000.00