Senior Manager, Member & Provider Services

Independent Living Systems; San Francisco (CA); On-site; USD 72,000 - 125,000; Full time

Job summary

Independent Living Systems in San Francisco, CA seeks a Manager, Member & Provider Services to oversee the daily operations of the contact center serving members and providers in the healthcare and social assistance sector. The role drives service quality, regulatory compliance, and cross-functional collaboration.

The manager will lead, mentor and develop a team, work with health plan clients and internal teams to optimize performance and outcomes while maintaining PHI/privacy standards and

Qualifications

• 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.
• 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 handle PHI and maintain HIPAA compliance.
• Ability to work independently and in a team to balance priorities and deadlines.
• Ability to work flexible hours to support operational requirements.

Responsibilities

• Lead daily operations of the Contact Center and ensure timely, effective resolution of inquiries to achieve FCR.
• Recruit, train, and develop staff; communicate updates through regular departmental meetings.
• Supervise, coach, mentor, and evaluate team performance against productivity and quality standards.
• Oversee investigation and resolution of complex member/provider cases; ensure contractual and regulatory compliance.
• Monitor turnaround times, SLAs, and performance metrics to ensure quality and customer satisfaction.
• Develop, implement, and maintain QA programs, workflows, and training materials.
• Collaborate with internal and external partners to resolve issues and improve service delivery.
• Ensure adherence to regulations, health plan requirements, and audit readiness.
• Attend meetings, trainings, leadership forums, and cross-functional workgroups.

Skills

Leadership

Analytical skills

Time management

Communication

HIPAA confidentiality

Education

Bachelor’s degree

Master’s degree

Tools

CRM software

EHR systems

Healthcare information systems

Job description

Independent Living Systems in San Francisco, CA seeks a Manager, Member & Provider Services to oversee the daily operations of the contact center serving members and providers in the healthcare and social assistance sector. The role drives service quality, regulatory compliance, and cross-functional collaboration.

The manager will lead, mentor and develop a team, work with health plan clients and internal teams to optimize performance and outcomes while maintaining PHI/privacy standards and