Manager, Member Services

Texas Children's Hospital; Bellaire (TX); On-site; USD 90,000 - 120,000; Full time

Job summary

Texas Children's Hospital is seeking a Manager of Member Services to lead a high‑performance, culturally competent customer service call center supporting a diverse membership and provider community.

You will evaluate staff development, service results, and processes to ensure excellence, satisfaction, and regulatory compliance, including HIPAA, CMS, and JCAHO. This role offers growth within a pediatric health system.

Qualifications

• 6 years of experience as a team leader or supervisor in Member Services, Claims Administration, Revenue Cycle, Financial Counseling or Provider Relations.
• Bachelor's degree in Business Administration, Health Administration, Marketing, or related field may substitute for four years of required experience.
• Ability to supervise, interview, assess and hire staff; ensure regulatory compliance.

Responsibilities

• Acts as an internal advocate for external customers, collaborating with other department managers to meet customers’ needs.
• Develops and implements training strategies that support quality objectives and continuous learning.
• Ensures compliance with regulatory and accrediting requirements (HIPAA, CMS, JCAHO, NCQA, etc.).
• Interviews, assesses, and selects candidates for hire.
• Participates in outreach to educate the community about pediatric health plan options.
• Ensures linkage between department requirements and the integrated delivery system.

Skills

Customer service leadership

Staff development

Training strategy

Regulatory compliance

Cross-functional collaboration

Education

Bachelor's degree in Business Administration or related field

High school diploma or GED

Job description

Job Description We are searching for a Manager of Member Services -- someone who works well in a fast-paced setting. In this position, you will manage a high performance, culturally sensitive and competent customer service Call Center that supports a rapidly growing, diverse membership and provider community and an expanding portfolio of health plan options. You will evaluate staff development, customer service results, and operational processes to ensure excellence in service, customer satisfaction, and compliance with accrediting and regulatory agencies.

Job Description We are searching for a Manager of Member Services -- someone who works well in a fast-paced setting. In this position, you will manage a high performance, culturally sensitive and competent customer service Call Center that supports a rapidly growing, diverse membership and provider community and an expanding portfolio of health plan options. You will evaluate staff development, customer service results, and operational processes to ensure excellence in service, customer satisfaction, and compliance with accrediting and regulatory agencies.

Think youve got what it takes?

Job Duties & Responsibilities

• Acts as an internal advocate for external customers, collaborating with other department managers to meet customers’ needs
• Develops and implements training strategies that support the quality objectives and creates a continuous learning environment for professional growth
• Ensures compliance with all regulatory (TDI, HIPAA, CMS, etc.) and accrediting (JCAHO, NCQA, etc.) requirements
• Interviews, assesses, and selects candidates for hire
• Participates in outreach activities designed to educate the community about available pediatric health plan options
• Ensures that JCAHO and CAP requirements specific to your department are fulfilled but also understand the linkage between your departments requirements and those of the integrated delivery system

Skills & Requirements

• High school diploma or GED required
• Bachelors degree in business administration, health administration, and marketing or related field preferred
• 6 yearsxperience as a team leader or supervisor in Member Services, Claims Administration, Revenue Cycle, Financial Counseling or Provider Relations required
• A Bachelors degree in Business Administration, Health Administration, Marketing, or a related field may be substituted for four years of required experience

About Us

Founded in 1996, Texas Childrens Health Plan is the nations first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Childrens Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Childrens Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Childrens is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Childrens without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.