Call Center Manager- IFG

Humana

3d • Remote

About The Position

The Innovative Financial Group (IFG) Call Center Manager is responsible for overseeing the daily operations of a Medicare-focused contact center, ensuring high-quality service, regulatory compliance, and achievement of performance goals. This role leads a team supporting Medicare Advantage, Part D, and related healthcare programs while driving operational excellence, member satisfaction, and CMS compliance.

Requirements

• Bachelor’s degree or equivalent experience
• Active Health Insurance License
• 2+ years of call center leadership experience in healthcare
• 2+ years of Medicare (Medicare Advantage, Part D, or CMS-regulated environment) experience
• Strong knowledge of CMS regulations, HIPAA, and Medicare compliance standards
• Proven experience managing KPIs, quality programs, and high-volume operations

Nice To Haves

• Experience supporting STAR Ratings, CAHPS, or HEDIS initiatives
• Managed care or health plan call center background
• Call center workforce management experience
• Lean, Six Sigma, or process improvement experience

Responsibilities

• Manage day-to-day operations of the Medicare call center, including inbound, outbound, enrollment, eligibility, claims, and benefits inquiries
• Ensure adherence to service level agreements (SLAs), KPIs, and productivity targets
• Monitor call volumes, staffing levels, schedules, and escalation processes
• Implement process improvements to increase efficiency and quality
• Ensure full compliance with CMS guidelines, Medicare regulations, HIPAA, and company policies
• Support CMS audits, internal audits, and compliance reviews
• Maintain documentation and workflows aligned to Medicare Advantage and Part D requirements
• Partner with Compliance and Legal teams to address regulatory updates
• Lead, coach, and mentor supervisors, team leads, and call center agents
• Conduct performance reviews, goal setting, and corrective action when needed
• Identify training needs and collaborate with Training teams to enhance Medicare knowledge and customer service skills
• Foster a culture of accountability, engagement, and continuous improvement
• Monitor quality assurance results and drive action plans for improvement
• Address member complaints, grievances, and escalations promptly and professionally
• Focus on improving CAHPS, STAR Ratings, and overall member satisfaction
• Ensure consistent delivery of accurate, empathetic, and compliant member interactions
• Analyze call center metrics including AHT, FCR, CSAT, adherence, and utilization
• Prepare and present performance reports to senior leadership
• Use data to identify trends, risks, and opportunities for operational improvement
• Partner with Enrollment, Claims, Care Management, IT, and Provider Services
• Support open enrollment and other peak periods with staffing and workflow planning
• Participate in system enhancements, implementations, and process redesigns

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• commission incentive plan

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees