Supervisor, Member Services

Inland Empire Health Plan•Rancho Cucamonga, CA

1d•$71,573 - $93,038•Hybrid

About The Position

Reporting to the Manager, Call Center, the Supervisor, Member Services oversees the day-to-day operations of an inbound and/or outbound Member Experience team. The supervisor drives high-quality member service by supporting recruitment, onboarding, coaching, mentoring, and performance monitoring. The role ensures adherence to policies, quality-assurance standards, and regulatory requirements while fostering a LEAN culture, encouraging Team Member development and innovation, and collaborating with departmental leaders to meet service and call center objectives. The supervisor maintains current training and operational materials and coordinates timely communication of state and internal updates. The position supervises Member Services Representatives and Coordinators, manages staffing and scheduling, monitors service quality and performance, resolves escalated member concerns, and leads outreach campaigns and process-improvement initiatives. It also supports compliance, employee engagement, training, and cross-functional coordination. The role contributes to IEHP’s Quality Program goals, including HEDIS, CAHPS, and NCQA Accreditation. This position follows a hybrid schedule: remote on Monday and Friday, and onsite Tuesday through Thursday in Rancho Cucamonga, California. The annual pay range is USD $71,572.80–$93,038.40.

Requirements

Two years of experience working directly with Medicare/Medi-Cal members.
Prior call center supervision or lead-capacity experience.
Three or more years of healthcare call center experience in a healthcare delivery setting.
High school diploma or GED.
Experience in an HMO or managed care environment.
Knowledge and understanding of Dual Choice products and/or Medicare and Medi-Cal product lines and programs.
Knowledge of medical terminology.
Strong written, verbal, and interpersonal communication skills.
Strong organizational and sound decision-making skills.
Ability to establish and maintain effective working relationships, supervise and train Team Members, and balance multiple projects while meeting deadlines.
Attention to detail.
Motivational and interpersonal skills with an emphasis on superior service.
Expertise using call center systems, including Verint, ADP, Cisco Finesse, telephones, and Cisco Jabber.
Public-speaking skills for conducting meetings and training and developing staff.
Interview skills.

Nice To Haves

Bachelor’s degree from an accredited institution.
Experience working directly with Medicare or Medi-Cal members in a call center environment.
Knowledge of IEHP product lines and programs.
Bilingual in Spanish and English.
Proficiency with Microsoft Word and Excel.
Familiarity with Team Members’ learning styles and thought processes to support effective coaching and communication of new processes.
Mentorship approaches that support individual growth and well-roundedness.

Responsibilities

Supervise day-to-day Member Experience operations, including a team of Member Services Representatives and Coordinators.
Ensure member inquiries and issues are addressed in a timely, knowledgeable, and efficient manner to meet service and call center goals.
Manage staffing levels, scheduling, and workforce coordination to meet service-level and quality goals.
Participate in hiring new Team Members.
Keep operational processes, procedures, and call center practices current, documented, and aligned with regulatory requirements.
Ensure member care is delivered with superior service and in accordance with IEHP benefits, policies, and procedures.
Lead and implement outreach call campaigns for member retention and regulatory or operational initiatives, including HEDIS initiatives or HRA.
Coach, evaluate, and develop Team Members using data-based decision-making, and ensure expectations and continuous improvement align with departmental goals.
Conduct call audits and quality reviews, identify training needs, and implement improvement plans.
Follow IEHP performance guidelines, including timely performance reviews and disciplinary action.
Mentor Team Members and provide skill-building, performance feedback, and professional development support.
Model integrity and ethical and professional conduct in alignment with organizational values.
Keep training materials, knowledge resources, processes, and job aids accurate, accessible, and current.
Partner with internal training and quality teams to develop and deliver training modules and operational updates.
Monitor regulatory and policy changes, communicate updates to the team, and ensure implementation.
Participate in operational and policy-related meetings and clearly communicate relevant updates to the team.
Ensure team practices meet compliance standards and organizational expectations for quality and service.
Help resolve discrepancies and escalated member concerns, ensuring timely follow-through and high-quality service.
Coordinate with Member Experience management on complex issues and follow through with members or Team Members until resolution.
Manage, resolve, and report case follow-up, web portal inquiries, chat, incoming mail, faxes, and walk-ins within the team’s responsibilities.
Identify trends in escalations and discrepancies and recommend preventive improvements.
Collaborate with cross-functional departments to provide coordinated service and seamless member experiences.
Identify inefficiencies and lead LEAN-driven process-improvement initiatives.
Analyze team and individual performance data, assess trends, identify root causes, recommend process changes, and develop and interpret performance reports.
Identify waste and recommend lean processes that improve efficiency and member retention.
Promote quality and continuous improvement, and lead implementation of process enhancements and projects.
Encourage open communication and listen to team feedback while fostering a positive team environment.
Work with the Leadership Team to align actions with IEHP’s vision and team culture.
Ensure team participation in the annual Employee Engagement Survey and facilitate discussions about results, feedback, expectations, and action plans.
Perform other duties as required to support Health Plan operations and departmental business needs.