Healthcare Member & Provider Services Lead

Independent Living Systems, llc; Riverside (CA); Vor Ort; USD 72.000 - 125.000; Vollzeit

Zusammenfassung

Independent Living Systems in Riverside, CA is seeking a Manager, Member & Provider Services to oversee the contact center supporting members and providers within healthcare. You will mentor a team, drive performance, and collaborate with health plans and internal teams to ensure service excellence and regulatory compliance.

The role focuses on leadership, process improvement, and adherence to HIPAA and data privacy standards while delivering exceptional service outcomes.

Qualifikationen

• Bachelor’s degree in Healthcare Administration, Business, or a related field.
• Minimum of 5 years of member or provider services in healthcare or social assistance, with at least 2 years in a supervisory role.
• Experience with Medi-Cal eligibility and benefits.

Aufgaben

• Lead and manage the daily operations of the Contact Center, ensuring timely and effective resolution of inquiries and issues.
• Recruit, train, and develop contact center staff to maintain high standards of customer service and operational efficiency.
• Oversee investigation and resolution of complex and escalated member/provider cases, ensuring compliance with contractual and regulatory requirements.

Kenntnisse

Leadership

Communication

Analytical

Time management

Ausbildung

Bachelor’s degree in Healthcare Administration, Business, or related field

Master’s degree in Healthcare Administration, Public Health, or Business Administration

Tools

CRM software

EHR systems

Healthcare information systems

Jobbeschreibung

Independent Living Systems in Riverside, CA is seeking a Manager, Member & Provider Services to oversee the contact center supporting members and providers within healthcare. You will mentor a team, drive performance, and collaborate with health plans and internal teams to ensure service excellence and regulatory compliance.

The role focuses on leadership, process improvement, and adherence to HIPAA and data privacy standards while delivering exceptional service outcomes.