Manager, Membership Services And Individual Services - 2025 - 1466 - 2367

Membership Services Manager

Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

Responsible for managing all commercial Membership Services teams. Produce accurate enrollment, timely billing, COBRA administration, and excellent customer service for our Commercial Group and COBRA customers. Maintain compliance of state laws, federal laws, and PacificSource contract guidelines pertinent to the commercial Membership Department. Maintain regular training programs and development of the staff. Hire and project department needs and budget accordingly. Attend appropriate meetings to ensure communication is shared and new technology is implemented.

Essential Responsibilities:

• Provide leadership directly to team leaders and indirectly to all department staff. Assure the team leaders understand their role and responsibilities involving leadership, workflow, quality, production and team member performance.
• Provide feedback including regular one on ones and performance evaluations for direct reports.
• Review exception request, make determinations that are in the best interest of the customer and assure PacificSource liability is within allowable limitations. Authorize group reinstatements or termination of group accounts for delinquent premiums and escalate to EMG member per policies. Resolve difficult issues with customers when request is escalated.
• Maintain or develop audit processes and/or reports as needed to ensure PaicificSource funds and customer eligibility is being securely processed and accounted for.
• Oversee the development and implementation of process and procedures to improve operational efficiency. Work with other departments to improve interdepartmental processes to improve service and customer satisfaction.
• Maintain regular training and coaching programs for new hires and existing staff. Ensure the Mentor training program is maintained and functional. Ensure the department trainers maintain a New Hire training program and co-share training across job functions.
• Communicate daily with all department Team Leaders and ensure positions/tasks are backed up at all times. Meet weekly with leaders to plan, clarify, develop, or change processes that affect the department or our customers.
• Review new and existing laws to ensure the Membership department is in compliance with our legal and regulatory requirements and PacificSource contracts.
• Responsible for oversight, management, development, implementation, and communication of department programs.
• Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
• Develop and monitor annual department budgets.
• Coordinate business activities by maintaining collaborative partnerships with key departments.
• Actively participate as a key team member in Manager/Supervisor meetings.
• Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.

Supporting Responsibilities:

• Develop relationships with PacificSource staff and build connections that enhance the PacificSource values.
• Strategize ways to allow for community service, while meeting department deadlines.
• Travel and or plan travel to other locations as needed to maintain a cohesive team and ensure processes are consistent where needed in all department locations.
• Meet department and company performance and attendance expectations.
• Perform other duties as assigned.

Success Profile

Work Experience:

Minimum of five years’ experience in health insurance or other related field required. Two years’ supervisor experience required.

Education, Certificates, Licenses:

High school diploma or equivalent required. BS in Business or accounting preferred.

Knowledge:

Requires outstanding customer service, verbal, telephone and written communication. Basic math skills required, including percentages, ratios, graphing and spreadsheet skills. Requires ability to define and prioritize problems and manage workload without direct supervision. Ability to manage workforce in multiple locations.

Competencies:

Building Trust Building a Successful Team Al