Supervisor, Member Services

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Reporting to the Manager, Call Center, the Supervisor, Member Services oversees the day-to-day operations of an inbound and/or outbound Member Experience team. This role drives best-in-class member service by assisting with recruitment, onboarding, mentoring/coaching, and monitoring performance of Team Members. This role ensures adherence to policies, quality-assurance standards, and regulatory requirements. The supervisor fosters a LEAN culture within the organization, encourages Team Member innovation and development and collaborates with departmental leaders to achieve IEHP’s overall service and call center objectives. The incumbent maintains up-to-date training and operational materials, in addition to coordinating timely dissemination of state and internal updates to their team.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Call Center Operations Management:

1. Supervise and oversee day-to-day Member Experience operations inclusive of a team of Member Services Representatives and Coordinators
2. Ensure daily inquiries/issues received by the team are answered in a timely, knowledgeable, and efficient manner to achieve 5 Star Service and call center goals
3. Manage staffing levels, scheduling, and workforce management coordination to meet service level and quality goals
4. Participate in hiring process of new Team Members
5. Ensure operational processes, procedures, and call center practices are current, documented, and aligned with regulatory requirements
6. Ensure member care is delivered with superior service and according to IEHP benefits, policies and procedures
7. Lead and implement outreach call campaigns for member retention and regulatory or operational initiatives (such as HEDIS initiatives or HRA)

Leadership, Coaching, Training and Development, & Performance Management:

1. Provide ongoing coaching, performance evaluations, and development opportunities for the team to maximize performance utilizing data-based decision making
2. Ensure clarity of expectations and continuous improvement are in alignment with departmental goals and expectations
3. Utilize different formats or approaches to evoke learning and implementation
   Conduct call audits and quality reviews to identify training needs and implement actionable improvement plans
4. Responsible for following IEHP performance guidelines in a timely manner, including performance reviews and disciplinary action
5. Support professional growth through mentoring, skill-building, and performance feedback
6. Lead by example, demonstrating integrity, standards of ethical and professional conduct, and alignment with organizational values
7. Ensure training materials, knowledge resources, and operational processes/job aids are accurate, accessible, and regularly updated
8. Partner with internal training and quality teams to develop and deliver new training modules and operational updates

Compliance, Policies, & Regulatory Alignment:

1. Stay current with regulatory changes and organizational policies impacting call center operations; ensure timely communication and implementation of updates to the team and processes
2. Participate in internal operational and policy-related meetings and communicate key updates to the team clearly and professionally
3. Ensure team practices meet compliance standards and organizational expectations for quality and service

Member Issue Resolution & Escalation Management:

1. Assist with and resolve discrepancies and/or escalated member concerns, ensuring timely follow-through and high-quality service
2. Initiate contact with Member Experience management on complex issues and complete follow through with member or Team Member until the issue is resolved
3. Manage, resolve, and report all case follow-up, web portal inquiries, chat, incoming mail, faxes, and walk-ins associated with the team’s responsibilities
4. Identify trends from escalations and discrepancies and recommend improvements to prevent recurrence and improve member experience
5. Collaborate with cross-functional departments to ensure seamless member experiences and coordinated service delivery

Process Improvement & Lean Initiatives:

1. Identify inefficiencies and lead LEAN-drive process improvement initiatives to enhance service delivery and operational effectiveness
2. Analyze individual and team performance data to assess trends, identify root causes, and recommend process changes
3. Develop, review and interpret team and individual performance reports to ensure team is continually performing at optimum levels
4. Identify areas of waste and suggest lean processes for efficiency gains and member retention
5. Promote a culture of quality and continuous improvement in all aspects of responsibilities
6. Lead the implementation of process enhancements and projects. Continually identify opportunities for process improvement, service enhancements, and member retention

Employee Engagement & Team Culture:

1. Foster a positive team environment by encouraging open communication and listening to team feedback
2. Work conjointly with the Leadership Team to ensure all actions are positive and are in line with IEHP’s Vision statement and Team Culture
3. Ensure team participation in the annual Employee Engagement Survey
4. Facilitate discussions regarding survey results and resulting action plans to clarify expectations:
   
   • Understanding of overall and department/team specific Employee Engagement Survey results
   • Ability to facilitate dialogue during feedback sessions.
   • Clear understanding of expectations
5. Perform any other duties as required to ensure Health Plan operations and department business needs are successful

Education & Experience

• Two (2) years of experience working directly with Medicare/Medi-Cal Members required. Prior call center supervision required
• Three (3) or more years of healthcare call center experience working in a health care delivery setting
• Experience in an HMO, Managed Care environment. Experience with Dual Choice Product and/or Medicare and Medi-Cal business practices
• High School diploma or GED required
  • Bachelor’s degree from an accredited institution preferred
• Prior call center supervisory/lead capacity required
  • Experience working directly with Medicare or Medi-Cal members in a call center environment a plus
• Strong knowledge and understanding of:
  • Dual Choice Product and/or Medicare and Medi-Cal product lines and programs
  • Medical terminology
  • Becoming familiar with Team Members’ learning styles and thought processes to become more effective with conveying new processes and coaching opportunities
  • Mentorship approaches ensuring individual growth and well-roundedness

Key Qualifications

• • Knowledgeable in IEHP product lines and programs preferred
  • Bilingual (Spanish/English) – preferred
• Proficient in microcomputer applications (Microsoft Word, Excel)
• Excellent written, verbal communication, and interpersonal skills
• Strong organizational skills and sound decision-making skills required
• Ability to establish and maintain effective working relationships with others, ability to supervise and train Team Members
• Ability to balance multiple projects while ensuring deadlines are met
• Detailed oriented
• Motivational and interpersonal skills are required with an emphasis on superior service. Expertise in utilization of all call center systems including Verint, ADP, Cisco Finesse, telephones, and Cisco Jabber
• Public Speaking skills to conduct meetings, train, and develop staff
• Interview skills

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA)

USD $71,572.80 - USD $93,038.40 /Yr.