Member Services Manager - Wall, New Jersey

Amynta Group • NJ - Remote, NJ

2d • $115,000 - $125,000 • Hybrid

About The Position

The Member Services Manager leads and develops Guided Health Concierge’s Care Guides and Billing Guides, ensuring members receive warm, accurate, proactive support. This hands-on leadership role includes assisting with hiring, onboarding and training team members; monitoring and coaching member interactions across phone, email and the member portal; handling complex cases and escalations; and overseeing quality reviews, audits and reporting. As the company adds clients, the manager will help plan future hiring and training and shape the member services team and its approach to service.

The manager oversees daily operations, staffing and schedules, queue and workload monitoring, handoffs, and adherence to service-level agreements, performance guarantees, quality standards, crisis protocols, HIPAA practices and scope boundaries. The role owns the member services scorecard and reporting, identifies trends and process improvements, and shares member feedback and insights with the Chief Client Officer. The position reports directly to the Chief Client Officer and has Care Guides and Billing Guides as direct reports.

Guided Health Concierge helps employers’ employees and families understand and use their benefits through technology and human support. The company supports benefits including medical, dental, vision, voluntary insurance, life and disability coverage. It launched in 2026 and serves employer groups nationally. The role is based in Central Monmouth County, New Jersey, with in-office work Monday through Thursday and remote work on Fridays. It is a full-time, salaried position. The team supports members Monday through Friday, 8 a.m. to 9 p.m. ET, and the manager may support evening coverage as needed. Pay is $115,000 to $125,000 per year, based on experience.

Requirements

• At least 5 years of experience in health advocacy, care navigation, health plan member services, benefits administration or medical billing, including at least 2 years leading a team.
• Deep knowledge of employer health benefits, including medical, pharmacy, dental, vision, HSAs, FSAs, HRAs, life, disability and voluntary benefits.
• Strong working knowledge of claims, EOBs, prior authorizations, denials and appeals, and medical billing.
• Demonstrated ability to coach people to deliver warm, high-quality service, including call monitoring and quality programs.
• Experience managing service-level agreements and metrics such as CSAT, NPS, response times and resolution times.
• Calm judgment when handling escalated and sensitive situations.
• Empathy and strong written and verbal communication skills with members and team members.
• Comfort working in a fast-growing startup environment.
• Strong understanding of HIPAA and protection of members’ health information.
• Bachelor’s degree.

Nice To Haves

• Experience launching or scaling a member services or advocacy team.
• Experience in the health insurance space.
• Experience with self-funded plans, reference-based pricing, PBMs and point solutions.
• Knowledge of the No Surprises Act, state balance billing laws, and ERISA claims and appeals rules.
• Experience with case management, CRM and call center systems, including call recording and quality tools.
• Medical billing or coding certification, or a health care advocacy credential.
• Bilingual in English and Spanish.

Responsibilities

• Assist with hiring, onboard and lead Care Guides and Billing Guides, and help expand the team as new clients are added.
• Build a team culture of warmth, ownership, accuracy and collaboration.
• Train new Guides using the company’s training program and resources, oversee certification, and keep training current as benefits, laws and clients change.
• Hold regular one-on-ones, set goals, write development plans, recognize strong work, and address performance concerns fairly and promptly.
• Ensure Guides consistently deliver a friendly, clear, proactive and persistent member experience.
• Review recorded and live calls, emails and portal messages; coach in the moment; and lead calibration sessions to support consistent quality scoring.
• Audit calls, emails, portal messages and cases from first contact through resolution for content, sentiment, accuracy, service-level agreement adherence and compliance, and use findings for coaching.
• Oversee escalations, including complaints and sensitive situations, and personally assist with complex cases.
• Lead regular reviews of cases and member interactions to maintain alignment with service standards.
• Ensure compliance with crisis protocols, HIPAA practices and scope boundaries.
• Manage staffing and schedules to provide coverage during supported hours, including rotating evening shifts and remote Fridays.
• Monitor queues, case aging and workloads in real time and adjust resources as needed.
• Ensure the team meets service-level agreements and performance guarantees for response time, resolution time and member satisfaction.
• Lead daily huddles and ensure complete, smooth handoffs between Care Guides and Billing Guides.
• Ensure the team follows company workflows and work with the Chief Client Officer on process improvements, gaps and opportunities.
• Own the member services scorecard, including timeliness, quality, CSAT, NPS and impact measures such as savings, billing corrections and appeals won.
• Prepare reports and insights for the Chief Client Officer.
• Identify trends in member requests, carrier problems and billing errors, and recommend fixes.
• Share member feedback with the Chief Client Officer to help improve technology and services.

Benefits

• Medical, dental and vision coverage.
• Flexible spending account (FSA) or health savings account (HSA), with a company contribution to the HSA.
• Company-paid life insurance.
• Paid time off and company holidays.
• Remote Fridays.
• Competitive pay.
• Many additional benefits.
• Opportunity to make a difference at a new company.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager