Client Services Manager

HealthOne Alliance•Dalton, GA

About The Position

The Client Services Manager is responsible for leading and continuously improving a multi-product call center to deliver accurate, compliant, and empathetic service to members, participants, clients, brokers, consultants and providers. This role provides strategic and operational leadership through direct-report and indirect-report structures, ensuring effective staffing, coaching, quality assurance, and performance management across day-to-day operations. The Client Services Manager oversees service delivery for benefit verification and explanation; premium billing support; provider participation; and claims research/explanation, and partners with internal departments to coordinate workflows, resolve systemic issues, and allocate resources to meet service level goals, administrative demands, and operational support needs.

Requirements

Bachelor’s Degree in Business, Health Care Administration, or related field preferred; or equivalent work experience
Four to five years broad-based management experience preferred
Minimum of two years in a lead or senior role in customer service environment preferred
Insurance experience required
Knowledge of healthcare billing and claims preferred

Nice To Haves

Bilingual preferred

Responsibilities

Leads call center strategy and day-to-day operations to deliver a consistent, high-quality client/member/provider/broker/consultant experience across all supported Company product lines.
Directly manages a leadership team; sets expectations, establishes rhythms (huddles/1:1s), and develops leaders to drive performance and engagement.
Plans and manages capacity and workflow across channels and work queues (inbound/outbound calls, CMS–HICS casework, GA Access tickets (TICS), billing/eligibility systems, and reception coverage as applicable) to meet service levels and turnaround times.
Establishes and maintains standard work, scripts/job aids, and training/coaching programs for Client Services team members in alignment with policies and regulatory requirements.
Owns escalation governance: reviews and resolves complex inquiries, assigns priority based on impact and urgency, and ensures timely, accurate responses and root-cause follow-up.
Receives, investigates, evaluates, and resolves escalated complaints and/or inquiries as needed, partnering with Compliance, Claims, Enrollment & Billing, UM/Medical Management and Provider Relations when appropriate.
Monitors quality and compliance, including HIPAA and internal policies; identifies trends, coaching opportunities, and risk areas, and implements corrective action plans.
Manages call center tools and processes (telephony/ACD, CRM or case management, knowledge base, and reporting) and partners with IT/Operations to resolve system issues and support enhancements.
Collaborates with the Client Services Operational Intelligence team to review and analyze daily, weekly, and monthly performance reports (e.g., service level, ASA, abandonment, handle time, first-contact resolution, quality scores, and backlog aging) and communicate results and action plans to leadership.
Leads continuous improvement efforts using data and feedback; streamlines workflows, reduces rework, and improves member/client outcomes while balancing cost and quality.
Partners with Human Resources and department leadership on hiring, onboarding, performance management, corrective action, and succession planning for call center staff.
Collaborates with the Client Services Operational Intelligence team to define training needs and ensure effective initial and ongoing training plans (benefits, billing, claims, provider participation, systems, soft skills), including refresher training aligned to quality findings.
Develops and maintains clear written procedures, workflows, and communications to support consistent execution and cross-functional alignment.
Maintains a positive, respectful work environment; addresses employee relations issues promptly and escalates concerns appropriately.
Ensures adherence to Company procedures and workflows; performs audits/monitoring as needed and documents findings and corrective actions.
Collaborates with cross-functional partners to define best practices, improve end-to-end processes, and implement changes that reduce member/client friction.
Partners with Company leadership on client/member service initiatives, operational planning, and change management; translates goals into measurable department objectives.
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned