Healthcare Member & Provider Services Leader

Independent Living Systems, llc; Los Angeles (CA); Presencial; USD 72 000 - 125 000; Tempo integral

Resumo da oferta

Independent Living Systems (ILS) in Los Angeles, CA is hiring a Manager, Member & Provider Services to oversee the contact center that supports members and providers in healthcare and social assistance. You will lead a team, drive performance through metrics, and ensure service quality and regulatory compliance.

The role emphasizes First Call Resolution, mentorship, and collaboration with clients and cross-functional teams to deliver exceptional service and outcomes.

Qualificações

• Bachelor’s degree in Healthcare Administration, Business, or related field.
• 5+ years of member or provider services in healthcare or social assistance; at least 2 years in a supervisory role.
• Experience with Medi-Cal eligibility and benefits.
• Experience using operational metrics, reports and quality audits to drive performance improvements.
• Strong organizational, analytical and time-management skills.
• Excellent communication, organizational and interpersonal skills.
• Ability to maintain confidentiality and handle PHI per HIPAA regulations.
• Ability to work independently and as part of a team; manage multiple projects.

Responsabilidades

• Lead daily operations of the Contact Center, ensuring timely resolution and First Call Resolution (FCR).
• Recruit, train, and develop staff; conduct regular departmental meetings to communicate updates.
• Supervise, coach, mentor, and evaluate team members against productivity and quality standards.
• Oversee investigation and resolution of complex member/provider cases with guidance on compliance.
• Monitor regulatory turnaround times, SLAs, and performance metrics to ensure customer satisfaction.
• Develop, implement and maintain QA programs, procedures, workflows, and training materials.
• Collaborate with internal and external partners to resolve issues and improve service delivery.
• Ensure adherence to HIPAA and other regulations; participate in audits and reporting.

Conhecimentos

Communication

Organizational skills

Analytical skills

Time management

PHI handling

Regulatory compliance

Leadership

Customer service

Formação académica

Bachelor’s degree in Healthcare Administration

Master’s degree in Healthcare Administration

Ferramentas

CRM software

Electronic Health Records (EHR)

Descrição da oferta de emprego

Independent Living Systems (ILS) in Los Angeles, CA is hiring a Manager, Member & Provider Services to oversee the contact center that supports members and providers in healthcare and social assistance. You will lead a team, drive performance through metrics, and ensure service quality and regulatory compliance.

The role emphasizes First Call Resolution, mentorship, and collaboration with clients and cross-functional teams to deliver exceptional service and outcomes.