Member & Provider Services Operations Manager

Independent Living Systems, llc; Bakersfield (CA); Presencial; USD 110 000 - 140 000; Tempo integral

Resumo da oferta

Independent Living Systems, LLC is seeking a Manager, Member & Provider Services to lead the contact center operations supporting members and providers in healthcare and social services. This role focuses on efficient, compliant handling of inquiries, coaching a high-performance team, and partnering with clients and internal teams to drive quality outcomes.

You will oversee performance metrics, implement process improvements, ensure PHI protection, and maintain service standards in a fast-paced,

Qualificações

• Bachelor’s degree in Healthcare Administration, Business, or related field.
• Minimum of 5 years of member or provider services in the healthcare or social assistance industry, with at least 2 years in a supervisory role.
• Experience with Medi-Cal eligibility and benefits.
• Demonstrated experience using operational metrics, reports, and quality audits to drive performance improvements.
• Strong organizational, analytical, and time-management skills with the ability to effectively manage multiple priorities and deadlines.
• Excellent communication, organizational, and interpersonal skills.
• Ability to maintain confidentiality and handle protected health information (PHI) in accordance with HIPAA regulations.
• Ability to work independently and as part of a team to balance competing priorities and manage multiple projects simultaneously.
• Ability to work flexible hours as needed to support operational requirements.

Responsabilidades

• Demonstrates commitment to Our Mission and models ILS Experience Standards of Excellence.
• Lead and manage the daily operations of the Contact Center, ensuring timely and effective resolution of all inquiries and issues leading to First Call Resolution (FCR).
• Recruit, train, and develop contact center staff to maintain high standards of customer service and operational efficiency; keep staff informed of updates through regular departmental meetings.
• Supervise, coach, mentor, and evaluate team members, establishing and monitoring productivity, quality, timeliness, customer service, and professional development standards to achieve departmental objectives.
• Oversee the investigation and resolution of complex and escalated member and provider cases, providing guidance to staff and ensuring compliance with contractual, regulatory, organizational, and client-specific requirements.
• Monitor regulatory turnaround times, service level agreements, and operational performance metrics to ensure timely resolution, quality outcomes, and customer satisfaction.

Conhecimentos

Leadership

HIPAA compliance

Communication

Operations metrics

Formação académica

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

Ferramentas

CRM software

EHR systems

Healthcare information systems

Descrição da oferta de emprego

Independent Living Systems, LLC is seeking a Manager, Member & Provider Services to lead the contact center operations supporting members and providers in healthcare and social services. This role focuses on efficient, compliant handling of inquiries, coaching a high-performance team, and partnering with clients and internal teams to drive quality outcomes.

You will oversee performance metrics, implement process improvements, ensure PHI protection, and maintain service standards in a fast-paced,