Healthcare Member Services Manager

General Dynamics Information Technology

. Lead a team of over 30 FTEs responsible for application and member request processing, call center services, and operational and data quality support .

Posted 5/7/2026full-timeRemote • 🇺🇸 United StatesSeniorLead💰 $110,500 - $149,500 per yearWebsite

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Lead a team of over 30 FTEs responsible for application and member request processing, call center services, and operational and data quality support
Serve as the main point of contact for our customer, working closely to resolve complex and sensitive applicant and member issues
Own workflow prioritization and service levels across all member touchpoints providing operational support, guidance, and subject-matter expertise for the member services team
Drive workforce management practices (forecasting, scheduling, adherence), while managing onboarding, training programs, and ongoing coaching programs, and performance reviews in collaboration with supervisory staff
Foster a member-first culture of accountability, service excellence, and continuous improvement
Manage performance against KPIs and AQL metrics (processing times, turnaround, quality, follow up activities, data accuracy, backlog/aging)
Conduct root-cause analysis on performance issues; implement data-driven corrective actions and continuous improvement initiatives
Partner with QA and Training to refine call handling, knowledge base content, and process SOPs
Collaborate with cross-functional teams to resolve member-impacting issues and streamline service processes
Track trends in member concerns, case types, and operational challenges; communicate insights to leadership
Partner with the business analyst team to continuously identify process improvements that enhance member experience, quality, and workflow efficiency and utilize data to improve operations, exchanges with trading partners, and identify new trends across the program
Ensure compliance with HIPAA and federal program requirements; maintain robust PHI safeguards and audit-ready documentation.

Requirements

What you’ll need

7+ years of progressive experience in health plan or TPA operations, specific to member services, customer service, and call center operations
5+ years of people leadership, managing teams in a high-volume service environment
Demonstrated track record of root-cause analysis, issue triage, and rapid corrective action
Strong command of call center operations, process optimization, and KPI/SLA management
Demonstrated ability to utilize automated tools to enhance daily operational processes
Proficiency with operational dashboards, ability to partner on SQL/Excel analyses and translate insights into action
Excellent communication and stakeholder management skills; able to brief government customer and collaborate with counterparts
HIPAA knowledge and commitment to protecting PHI

Benefits

Comp & perks

Variety of medical plan options, some with Health Savings Accounts
Dental plan options
Vision plan
401(k) plan with company match
Full flex work weeks where possible
Variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave
15 days of paid leave per calendar year for vacations, personal business, and illness
10 paid holidays per year
Paid Family Leave program provides up to 160 hours of paid leave in a rolling 12 month period for eligible employees
Short and long-term disability benefits
Life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

root-cause analysisissue triageprocess optimizationKPI managementSLA managementoperational dashboardsSQLExceldata-driven corrective actionsworkflow efficiency

Soft Skills

people leadershipcommunicationstakeholder managementcollaborationcoachingperformance managementservice excellenceaccountabilitycontinuous improvementproblem-solving