Strategic Member Services Leader - Compliance & Training

Community First Health Plans; San Antonio (TX); On-site; USD 65,000 - 95,000; Full time

Job summary

Community First Health Plans in Texas is seeking a senior supervisor to lead the Member Services Commercial, Health Exchange and CHIP hotlines. You will drive performance, ensure HIPAA compliance, and coordinate with cross-functional teams to resolve complex inquiries for members.

The role requires strong supervisory experience in health care call centers, knowledge of managed care, and proficiency with Excel/Access to analyze trends and generate actionable reports.

Qualifications

• Supervisory experience in health care call centers required.
• Strong knowledge of managed care and enrollment processes.
• Proficiency in Excel or Access required.

Responsibilities

• Directs and oversees Member Services call center operations.
• Ensures compliance with HIPAA, audits, and regulatory standards.
• Trains staff and develops best practices for customer service.
• Coordinates with other CFHP departments as needed for issue resolution.

Skills

Supervisory experience

Health care administration

Managed care

Call center leadership

Excel/Access

Education

Bachelor’s degree or 4 years of supervisory experience in health care administration

Tools

ACD Phone Software

Mainframe systems

MS Office

Job description

Community First Health Plans in Texas is seeking a senior supervisor to lead the Member Services Commercial, Health Exchange and CHIP hotlines. You will drive performance, ensure HIPAA compliance, and coordinate with cross-functional teams to resolve complex inquiries for members.

The role requires strong supervisory experience in health care call centers, knowledge of managed care, and proficiency with Excel/Access to analyze trends and generate actionable reports.