We are seeking an experienced Member Services Manager to lead a virtual team supporting members enrolled in New York Medicaid programs. This role oversees day-to-day contact center operations, team performance, scheduling, member engagement, and service quality within a high-volume, compliance-driven environment.
This is a remote position; however, candidates must live within a commutable distance of New York City and be available for occasional in-person meetings.
Key Responsibilities
- Oversee daily operations of a virtual member services/contact center team
- Lead, coach, and develop Social Care Coordinators, Screeners, Navigators, Intake Coordinators, Case Managers, and other member support staff
- Manage a team of 10+ employees and partner with Team Leads to monitor daily performance
- Manage staff scheduling and ensure adequate coverage across member service hours
- Monitor KPIs, productivity, quality, and member engagement metrics
- Identify performance trends and implement corrective action plans when needed
- Manage escalated member and operational issues
- Ensure accurate documentation and adherence to established workflows
- Maintain compliance with Medicaid, HIPAA, NYS DOH, and NYS 1115 Waiver requirements
- Support member screening, navigation, social care coordination, and retention efforts
- Partner with clinical, operations, and network teams to support referrals and continuity of care
- Support employee onboarding, training, coaching, and professional development
- Prepare operational reports covering team performance, capacity, member outcomes, and program trends
Required Qualifications
- Associate degree or higher
- 5–7 years of experience in customer service, contact centers, social services, care navigation, member services, or a related field
- Experience managing a team of 10+ employees
- Experience working in a virtual contact center environment
- Fully bilingual in English and either Spanish or Mandarin
- Must be fluent in speaking, reading, and writing in both English and the second language
- Strong people management, coaching, and communication skills
- Ability to manage escalations and resolve complex member or operational issues
- Must reside within a commutable distance of New York City for occasional in-person meetings
Preferred Qualifications
- Medicaid or NYS 1115 Waiver experience
- Experience with Social Care Networks (SCNs) or health-related social needs (HRSN) programs
- Healthcare, care coordination, patient support, or community-based services experience
- Five9 experience
- Medical, dental, and vision insurance
- 401(k)
- Employee meal discounts
Schedule
Monday–Friday, 9:00 AM–6:00 PM, with the possibility of occasional Saturday shifts