Senior Manager, Member Services
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Job Description
Senior Manager managing a high-volume outreach center for healthcare programs. Leading teams to improve member engagement and drive measurable health outcomes.
Responsibilities:
- Own day-to-day outreach center performance: inbound and outbound call handling, campaign execution, scheduling, workforce management, and real-time quality monitoring.
- Manage and optimize calling campaigns in Five9 or a comparable platform, including call routing, queue management, and agent productivity.
- Analyze contact center KPIs to identify trends, address performance gaps, and continuously improve member engagement outcomes.
- Build and maintain a QA framework that ensures consistent call quality, HIPAA compliance, and audit-ready documentation.
- Drive measurable outcomes against value-based care goals: care gap closures, Annual Wellness Visits, Health Risk Assessments, HEDIS measures, Patient Reported Assessments, and SDOH initiatives.
- Monitor the impact of quality and risk adjustment activities; develop corrective action plans when performance trends indicate risk.
- Track and report KPIs across outreach effectiveness, care gap completion, and value creation; present results to senior leadership.
- Lead Team Leads as direct reports, setting performance expectations, providing coaching, and holding the supervisory tier accountable for frontline outcomes.
- Manage staffing models, scheduling, and workload distribution across the team.
- Develop and deliver training that builds frontline capability and keeps the team equipped to meet evolving program requirements.
- Establish a performance culture with clear goals, regular evaluations, and visible career progression for frontline staff.
- Partner with Technology, Product, Data, and Finance to improve dashboards, automation, and reporting capabilities.
- Collaborate across departments to support new client requirements and align Member Services with broader organizational goals.
Requirements:
- 7+ years of progressive leadership experience in healthcare or managed care operations, with meaningful time managing a contact center or outreach function at scale.
- Hands-on experience with Five9 or a comparable contact center platform, including campaign management, queue monitoring, and workforce reporting.
- Demonstrated experience leading large frontline teams in a healthcare or managed care environment.
- Familiarity with value-based care metrics: care gap closures, HEDIS, SDOH, HRA, AWV, and related quality programs.
- Strong analytical skills and comfort making data-driven decisions in a fast-moving environment.
- Excellent communication and interpersonal skills — able to lead across levels and collaborate effectively with cross-functional partners.
- Knowledge of HIPAA and applicable healthcare compliance standards.
- Bachelor’s degree in Business Administration, Healthcare Management, or a related field; Master’s degree a plus.
- Proficiency in Google Workspace.
- Clinical background or experience in a health plan or value-based care setting. (Nice to have)
- Experience with Salesforce and Tableau. (Nice to have)
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 and 9 company holidays and a PTO accrual that grows with tenure
- Remote-first culture with periodic travel to our growth markets
- The chance to build something that matters — and to see the direct impact of your work on communities across the country
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