Member & Provider Services Leader

Independent Living Systems, llc; Modesto (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Independent Living Systems (ILS) is seeking a Manager, Member & Provider Services to lead the contact center dedicated to supporting members and providers in healthcare and social assistance. You will mentor a team, drive performance, and collaborate across departments to ensure compliant, high-quality service delivery.

Responsibilities include overseeing daily operations, guiding process improvements, and ensuring First Call Resolution while maintaining confidentiality and HIPAA standards.

Qualifications

• Requires a Bachelor’s degree in Healthcare Administration, Business, or related field.
• Minimum 5 years in 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.
• Uses operational metrics, reports, and quality audits to drive performance.
• Strong organizational, analytical, and time-management skills.
• Excellent communication and interpersonal skills.
• Ability to handle PHI per HIPAA regulations.

Responsibilities

• Oversee daily operations of the Contact Center ensuring timely resolution of inquiries.
• Hire, train, and develop staff; conduct regular meetings to share updates.
• Coach and evaluate team performance to meet productivity and quality standards.
• Manage escalation processes and ensure compliance with contractual, regulatory, and client requirements.
• Monitor service levels and key performance indicators to drive service excellence.
• Develop and maintain QA programs, procedures, and training materials.
• Collaborate with internal/external partners to improve service delivery and outcomes.
• Ensure adherence to HIPAA, confidentiality, and audit requirements.

Skills

Leadership

Project management

Communication

Analytical thinking

HIPAA compliance

Multi-tasking

Team development

Education

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

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

Tools

CRM software

EHR systems

Regulatory reporting tools

Job description

Independent Living Systems (ILS) is seeking a Manager, Member & Provider Services to lead the contact center dedicated to supporting members and providers in healthcare and social assistance. You will mentor a team, drive performance, and collaborate across departments to ensure compliant, high-quality service delivery.

Responsibilities include overseeing daily operations, guiding process improvements, and ensuring First Call Resolution while maintaining confidentiality and HIPAA standards.