Member Services Manager
Company: US Family Health Plan- A TRICARE Prime option
Location: New York City
Posted on: January 27, 2026
|
|
|
Job Description:
Job Description Job Summary The Manager of Member Services is a
key member of the management team whose primary concern is
facilitating optimal organizational performance for the Member
Services Department. Reporting directly to the COO, the Manager’s
primary responsibility is to oversee daily operations, ensuring the
department works seamlessly to achieve organizational objectives.
The Manager drives process improvements, optimizes resource
allocation, and fosters a culture of operational excellence.
Responsibilities Manage the day-to-day operations of the Member
Services Department, directly or through delegated authority to
department supervisors. Lead the development of the operational
components of the Member Services Department to ensure alignment
with the health plan’s strategic plan; review activities, set
direction, strategize around opportunities and threats, and review
goals, objectives, and outcomes on an ongoing basis. Identify
learning needs and advocate for training and technical support to
properly implement departmental policies and procedures;
continually educate and empower department supervisors/managers to
inform, train and support all staff members. Ensure the
development, integration, effective management, and sustainability
of accurate and efficient systems, and policies and procedures for
the departments’ operational functions. Plan, organize, and
evaluate various projects, programs and services involving
department operations; oversee or manage specific projects,
programs, and services as required. Collaborate with executive
leadership to identify ways to support the health plan’s mission,
vision, values, and goals through effective talent management,
including recruiting, hiring and retention strategies, succession
planning, career laddering, onboarding, training, professional
development, and performance assessment and recognition. Establish,
maintain, and evaluate departmental readiness including the
maintenance of accurate and efficient operations; cultivate
mutually beneficial partnerships with vendors and other business
partners; maintain current knowledge of the healthcare industry and
TRICARE policies. Ensure department performance meets/exceeds
organizational goals and TRICARE standards. Design and implement
policies, procedures, and systems to manage, measure, analyze and
improve departmental performance via quality improvement, resulting
in measurable high-quality service delivery, increased operational
efficiency and cost-effectiveness, and improvements in beneficiary
satisfaction and health plan recognition. Facilitate the
development of knowledge, attitudes, skills, and behaviors
necessary for team members to function together with a high degree
of engagement and satisfaction, attaining the highest possible
levels of effective performance. In collaboration with the IT
department, participate in the evaluation, selection, and
implementation of technology and software that will optimize the
member and employee experience, and facilitate the integration of
technology to optimize department operations. Demonstrate clear,
effective, and efficient communications, including the use of
effective listening skills and constructive feedback; prepare
reports and documents and utilize communication strategies to
promote stakeholder understanding; plan and conduct impactful and
productive business meetings. Conduct or participate in focused
internal audits of department policy and procedure adherence as
well as coordinating audits generated by external sources, such as
The Defense Health Agency, URAC, or other regulatory bodies.
Demonstrate commitment to the highest standards of ethical
responsibility, credibility, objectivity, accountability, and
trustworthiness. Other responsibilities as assigned. Competencies
Strong advocate for policy development, improvement, and compliance
that ensures personal accountability throughout the managed
departments. Able to discuss, incorporate, and apply effective
management techniques and theories in leadership activities.
Ability to serve as a subject matter expert, technical expert, and
thought leader on issues and provide guidance, develop solutions
for both predictable and unpredictable events or circumstances, and
develop others/teams. Able to proactively engage with direct and
indirect reports, provide guidance, set expectations for meeting
goals and priorities, and develop corrective action plans when
goals are not met. Ability to identify mission-centric
opportunities for stakeholder engagement, community outreach, and
managed departments while ensuring process focus on strategic
business drivers including growth, service, quality, people,
financial health, and key internal and external relationships. Able
to develop and communicate a clear vision and strategy for managed
departments that aligns with the health plan’s goals and
objectives, and can anticipate and respond effectively to changes
in the external environment. Ability to forecast staffing
requirements and patterns to support strategic growth or shifts in
health plan personnel availability. Able to ensure staffing
requirements and patterns meet health plan
regulatory/accreditation/compliance requirements. Ability to set a
consistent and strong example for upholding fair and honest ethical
and moral standards. Be an advocate for ideas based on facts and
experience. Proactively and continually assess personal strengths
and challenges and manage learning and guidance needs. Supervises
the Following Department or Program Leaders (1 FTE) Direct report;
Member Services Supervisor Experience At least five (5) years
managing or supervising a customer service or call center
department in a health plan or managed care setting. Proven ability
to manage multiple projects and priorities simultaneously. Previous
experience with development and implementation of health care
organizational policies and procedures. Proven problem solving,
program-development, team-building and training skills required.
Education/Background Check Bachelor’s degree, healthcare management
preferred, or equivalent experience Masters in Health Care
Administration preferred SALARY RANGE: $100,000.00 – $105,000.00
Benefits Statement SVCMC, Inc. provides a robust benefits package
that includes medical coverage through UnitedHealthcare/Oxford with
no deductible for in-network services. Employees also receive
vision coverage through UnitedHealthcare Vision and dental benefits
through MetLife. Basic life and disability insurance are
automatically provided at no cost. All employees are eligible for
commuter benefits, tuition reimbursement, and a 401(k)retirement
plan with an immediate employer match that is fully vested from day
one. SVCMC also offers a generous time off package, which includes
vacation, 10 paid holidays, and 3 personal days. Additionally,
employees have access to a comprehensive Employee Assistance
Program and exclusive discounts through Working Advantage. SVCMC IS
AN EQUAL OPPORTUNITY EMPLOYER – ALL QUALIFIED APPLICANTS WILL
RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO PROTECTED
VETERAN STATUS, DISABILITY, OR OTHER CHARACTERISTICS PROTECTED BY
LAW.
Keywords: US Family Health Plan- A TRICARE Prime option, New York , Member Services Manager, Healthcare , New York City, New York
