Customer Service Supervisor (Healthcare)

CentivoBuffalo, NY
$70,000 - $75,000Onsite

About The Position

The Supervisor, Member Care, plays a critical role in delivering on Centivo's promise to members, employers, and providers. This position leads a team of Member Care Specialists (MCSs), serving as the first line of supervisory support, coaching, and accountability for day-to-day team performance. The Supervisor ensures service levels and client SLAs are consistently met, escalations are resolved with urgency and care, and every member interaction reflects Centivo's commitment to high-quality, personal support. This is a client-facing role that requires confidence in presenting performance updates and operational summaries to external stakeholders. The ideal candidate brings a combination of operational discipline, people-first leadership, and a genuine commitment to making healthcare work for real people.

Requirements

  • Minimum 3 years of supervisory or management experience in a customer service or operations environment
  • Minimum 2 years of experience in a TPA, health insurance, or employee benefits setting
  • Working knowledge of CPT codes, ICD-9/ICD-10 coding, and medical terminology
  • Demonstrated ability to communicate professionally in both written and verbal formats
  • Experience working in a regulated environment with adherence to HIPAA and/or data privacy requirements
  • Proficiency in Microsoft Office and the ability to learn new proprietary systems
  • High school diploma required

Nice To Haves

  • Experience with health plan claims adjudication — either through direct claims processing or by supervising a team responsible for claims adjudication
  • Experience leading a team with dual responsibility for both member-facing customer service and claims adjudication; candidates who have managed this combined scope are strongly preferred
  • Associate's or bachelor's degree in a related field
  • Experience with call center platforms or CRM/ticketing tools
  • Familiarity with self-funded employer health plan structures and ERISA-governed benefit plans

Responsibilities

  • Supervise, guide, and coordinate the daily activities of the Member Care Specialist team, including workload distribution, scheduling, and real-time queue management.
  • Monitor individual and team performance against established SLAs, KPIs, and quality standards; track and report metrics and escalations to the Director regularly.
  • Serve as the first point of escalation for complex member, provider, or client inquiries; ensure timely resolution and appropriate follow-through on all escalated issues.
  • Coach and develop team members through ongoing feedback, recognition, and targeted training; assess individual training needs and instruct new team members during onboarding.
  • Conduct regular performance check-ins and contribute to formal performance reviews; document performance issues and support the performance management process in partnership with the Director.
  • Compile and present client-facing operational updates, including volume, quality metrics, and escalation summaries, on weekly or as-needed client calls.
  • Maintain current knowledge of Centivo's products, processes, client configurations, and regulatory requirements, including HIPAA and data privacy laws.
  • Ensure the team adheres to all compliance standards, policies, and best practices, including data security and confidentiality requirements.
  • Operate as a backup for other Supervisors as needed to ensure continuity of service.
  • Answer overflow inbound and outbound calls, emails, and faxes as operational needs require.

Benefits

  • free primary care (including virtual)
  • predictable copay
  • no-deductible benefit plan design
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