Healthcare Customer Service Manager

Advanced Health•Coos Bay, OR

1d•Onsite

About The Position

The Healthcare Customer Service Manager leads the daily operations of the Customer Service team, ensuring timely, accurate, and respectful service to members and other customers. The manager oversees staff performance and development, promotes compliance with organizational policies and applicable requirements, and works across departments to address service needs. The role uses member feedback and performance results to improve processes and service quality while aligning department operations with the organization’s mission and strategic goals. This is an exempt, full-time, onsite position based at the Coos Bay office. The stated schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m., although hours and staff scheduling may vary based on operational needs. The position oversees Member Services staff and reports to the Director of Member Services. The salary range is $2,446.15–$3,669.23 biweekly. The manager supervises Customer Service operations and staff, including workload planning, performance monitoring, training, coaching, quality reviews, audit preparation, and corrective action as appropriate. The role also handles escalated member concerns, reviews service data and feedback, coordinates with other departments, and identifies and implements improvements to service delivery and equitable access. The position may involve local travel, with occasional out-of-area travel, and requires frequent communication, computer use, telephone work, and handling interruptions.

Requirements

Three to five years of progressively responsible customer service experience.
Working knowledge of call center operations, including service levels, scheduling, quality monitoring, escalation management, and performance metrics.
Demonstrated ability to analyze operational and member service data, identify trends, monitor performance, and use data to support process improvements and decision-making.
Technical experience with customer service, call center, customer relationship management, workforce management, or related systems.
Ability to interpret and explain complex benefit and coverage information clearly.
Strong computer and data analysis skills; proficiency in Microsoft Office Suite and Windows Operating System.
Critical attention to detail, organization, initiative, judgment, discretion, and decision-making.
Ability to report to work as scheduled and work a flexible schedule when needed.
Ability to communicate professionally in writing and conversation and work effectively with diverse populations and people with differing personalities and backgrounds.
Ability to handle stress and sensitive situations professionally, de-escalate difficult interactions, resolve escalated member concerns, and recognize when additional support is needed.
Ability to identify ways to improve quality, productivity, and customer service; assess staffing needs, monitor call volumes, and adjust assignments to maintain responsive service.
Ability to use phone systems and system reports to supervise department and individual performance.
Strong problem-solving and decision-making skills and ability to provide team leadership, coaching, and mentoring in a complex and changing environment.
Knowledge of evidence-based practices and requirements for evaluating existing standards and implementing procedures; understanding of population health principles and basic managed care concepts.
Knowledge of federal and state laws, including OSHA and HIPAA, and awareness of waste, fraud, and abuse.
Understanding of equity, diversity, inclusion, and use of an equity lens, including analysis of social, political, and environmental contexts affecting policies, programs, and practices.
Ability to work under frequent interruption and stay on task.
Ability to remain stationary, occasionally move about the office to access equipment, and frequently communicate and exchange accurate information.
Bachelor’s degree in healthcare administration, business, public health, or a related field is strongly preferred; experience in lieu of education may be considered.

Nice To Haves

Three years of supervisory or team lead experience is strongly preferred.
Experience working in healthcare, managed care, or another health plan setting is strongly preferred.
Traditional Health Worker Certification is preferred or required within one year of hire.
Knowledge of OHP program requirements, benefit packages, eligibility categories, and Oregon Division of Medical Assistance Program rules and regulations is preferred.
Knowledge of Oregon Health Authority Coordinated Care Organization required metrics.
Training in or awareness of health literacy, poverty-informed practice, systemic oppression, language access and healthcare interpreters, using data to advance health equity, cultural awareness, trauma-informed care, Adverse Childhood Experiences, Culturally and Linguistically Appropriate Services Standards, and universal access.

Responsibilities

Manage daily Customer Service team operations, including staffing, workflow, and workload distribution.
Monitor call center and service performance metrics, including abandoned calls and wait times, and analyze telephone reports and other operational data.
Identify opportunities to improve operational efficiency and service delivery, and propose and implement effective policies, procedures, objectives, and practices.
Manage quality and audit programs, including telephone quality reviews, calibration sessions, audit preparation, documentation, and follow-up on findings.
Develop and revise member-facing communications and materials in required formats, including bilingual and large-print versions.
Apply a health equity lens to Customer Service operations by identifying and addressing barriers to equitable access and service.
Coordinate and collaborate with other departments to resolve service needs and escalated member concerns, address recurring issues, and support consistent service delivery.
Stay informed about customer service best practices and recommend operational improvements.
Work with organizational development staff to develop and maintain Customer Service Representative training programs.
Create and update documentation and resource materials; provide staff with training, tools, and resources.
Communicate changes in policies, procedures, and service expectations, and ensure adherence to organizational standards and requirements.
Lead the team in achieving goals and objectives, monitor progress, address barriers, prioritize workloads, and ensure assignments and reports meet deadlines.
Coordinate cross-training to support staff development and continuity of operations.
Review customer feedback, service trends, and recurring concerns to improve processes and service delivery.
Follow through on commitments and communicate updates promptly; handle confidential information appropriately and maintain a secure work area.
Participate in organizational quality and process improvement activities and support safety, quality, and risk management efforts.
Collaborate respectfully across the organization, mentor coworkers, provide excellent internal and external customer service, pursue continuing education, and represent the organization at meetings and conferences as applicable.
Plan, orient, assign, and support staff work in alignment with organizational goals and the Strategic Plan.
Establish and monitor staff performance, assign accountabilities, set objectives and priorities, and conduct regular check-ins.
Ensure completion of annual Development Reviews and recommend merit wage adjustments as appropriate and in accordance with policy.
Conduct formal and informal performance evaluations; coach staff and address performance or conduct concerns, coordinating corrective action with Human Resources and department leadership as appropriate.
Assist with recruitment, hiring, orientation, development, and evaluation of assigned staff; promote retention, productivity, and satisfaction through support, coaching, empowerment, and teamwork.
Ensure staff compliance with organizational policies and procedures and support employees in interpreting and applying them.
Support staff engagement, team building, problem solving, and cross-training; back up assigned staff workloads when necessary.
Provide clear instruction and practical training, communicate consistently with direct and indirect staff, and document performance and conduct concerns promptly.