Manager, Member Services

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. 

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

Manager of the Duals Phone team within Member services with Supervisors with direct reports reporting to them.

The Manager, Member Services oversees the Member Services Service Center and initiatives associated with member satisfaction.

Job Description

Key Responsibilities/Duties – what you will be doing

• Lead, Manage, and support the team of advocates responsible for supporting our Duals Membership.
• Facilitates the achievement of service level goals in Member Services and all related production metrics.
• Develops, coaches, and motivates Member Services Supervisors. Works with Supervisors to engage and motivate staff. Effectively manages critical dependencies that influence the daily success of the call center.
• Provides proactive strategic recommendations to improve performance, quality, efficiency, and customer experience.
• Works collaboratively with workforce management to make staffing recommendations and develop long term forecasts.
• Monitors and directs activities to improve satisfaction for both members and providers.

• Accountable for understanding and management of compliance standards. Assures operating budget targets are achieved.
• Collaborates with the partner departments, reporting and workforce management to ensure optimal accuracy and timeliness of data and reporting.
• Works collaboratively with Operations Quality Assurance to ensure optimal quality results.
• Works collaboratively with A&G, Claims, Care Management and Pharmacy Operations to improve workflows and communications while ensuring compliance standards are met.

• Participates in strategic work and decisions.
• Maintains awareness of all industry standards for operational and technical areas ensures that the company is leveraging the most appropriate technologies and practices,
• Develops collaborative approaches to resolve issues within the company to optimize satisfaction/service for members.

• Other duties and projects assigned.

Qualifications – what you need to perform the job

Certification and Licensure

Education

• Required (minimum): BS/BA degree or equivalent experience
• Preferred: MBA desirable

Experience

• Required (minimum): 5-7 years of Call Center management experience. Experience in healthcare management. Understanding of current call center technologies.
• Preferred:

Skill Requirements

• Requires analytical skills to define areas of need and identify appropriate solutions.
• Exhibits a high degree of motivation, creativity, and initiative.
• Requires excellent verbal and written communication skills.
• Must possess leadership skills that support the right behaviors to succeed.
• Must be able to work productively with Member Service Advocates, Supervisors, fellow managers, and all areas of the company.

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of emplo