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US Family Health Plan- A TRICARE Prime option · 9 hours ago

Senior Manager of Member Services and Enrollment

NYC Metro Area

Full-time

Onsite

Mid, Senior Level

$110K/yr - $115K/yr

5+ years exp

US Family Health Plan is a TRICARE Prime option organization seeking a Senior Manager of Member Services and Enrollment. The role involves overseeing daily operations of the Member Services and Enrollment Departments, driving process improvements, and ensuring alignment with organizational objectives.

Military

Growth Opportunities

No H1B

Security Clearance Required

U.S. Citizen Only

Responsibilities

Manage the day-to-day operations of the Member Services and Enrollment Departments, directly or through delegated authority to department supervisors. Lead the development of the operational components of the Member Services and Enrollment Departments 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

Qualification

Healthcare managementPolicy developmentProject managementTeam buildingTechnical expertiseStakeholder engagementTraining skillsEthical standardsCommunication skillsProblem solving

Required

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

Preferred

Bachelor's degree, healthcare management preferred, or equivalent experience

Masters in Health Care Administration preferred

ADP II security clearance required (United States government-designated level of clearance). Employee must successfully obtain ADP II security clearance. Employment will be terminated if employee does not obtain ADP II security clearance