Customer Service Supervisor (Healthcare)
Buffalo, IA - USA
Department:
Job Summary
We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable high-quality healthcare to the millions who struggle to pay their healthcare bills.
Summary of Role:
The Supervisor Member Care plays a critical role in delivering on Centivos promise to members employers and providers. This position leads a team of Member Care Specialists (MCSs) serving as the first line of supervisory support coaching and accountability for day-to-day team performance. The Supervisor ensures service levels and client SLAs are consistently met escalations are resolved with urgency and care and every member interaction reflects Centivos commitment to high-quality personal support.
This is a client-facing role that requires confidence in presenting performance updates and operational summaries to external stakeholders. The ideal candidate brings a combination of operational discipline people-first leadership and a genuine commitment to making healthcare work for real people.
Responsibilities Include
Supervise guide and coordinate the daily activities of the Member Care Specialist team including workload distribution scheduling and real-time queue management.
Monitor individual and team performance against established SLAs KPIs and quality standards; track and report metrics and escalations to the Director regularly.
Serve as the first point of escalation for complex member provider or client inquiries; ensure timely resolution and appropriate follow-through on all escalated issues.
Coach and develop team members through ongoing feedback recognition and targeted training; assess individual training needs and instruct new team members during onboarding.
Conduct regular performance check-ins and contribute to formal performance reviews; document performance issues and support the performance management process in partnership with the Director.
Compile and present client-facing operational updates including volume quality metrics and escalation summaries on weekly or as-needed client calls.
Maintain current knowledge of Centivos products processes client configurations and regulatory requirements including HIPAA and data privacy laws.
Ensure the team adheres to all compliance standards policies and best practices including data security and confidentiality requirements.
Operate as a backup for other Supervisors as needed to ensure continuity of service.
Answer overflow inbound and outbound calls emails and faxes as operational needs require.
Qualifications
Required:
Minimum 3 years of supervisory or management experience in a customer service or operations environment
Minimum 2 years of experience in a TPA health insurance or employee benefits setting
Working knowledge of CPT codes ICD-9/ICD-10 coding and medical terminology
Demonstrated ability to communicate professionally in both written and verbal formats
Experience working in a regulated environment with adherence to HIPAA and/or data privacy requirements
Proficiency in Microsoft Office and the ability to learn new proprietary systems
High school diploma required
Preferred:
Experience with health plan claims adjudication either through direct claims processing or by supervising a team responsible for claims adjudication
Experience leading a team with dual responsibility for both member-facing customer service and claims adjudication; candidates who have managed this combined scope are strongly preferred
Associates or bachelors degree in a related field
Experience with call center platforms or CRM/ticketing tools
Familiarity with self-funded employer health plan structures and ERISA-governed benefit plans
Work Location
Buffalo-based office
Leadership Skills & Behaviors
Business Acumen A keenness and quickness in understanding and dealing with a business situation in a manner likely to lead to a good outcome. Able to think beyond their immediate team to understand the broader impact of operational decisions.
Flexibility / Working Through Ambiguity Energized by new challenges; able to consider different perspectives and work with incomplete information to arrive at practical actionable next steps.
Systems Thinking Able to see how processes connect upstream and downstream; anticipates the ripple effects of changes and proactively flags potential impacts.
People Manager Leadership Behaviors (The 5 Cs)
Communicate Discusses team direction goals and in times of uncertainty what we know and dont know so team members always understand what matters and why.
Clarify Sets clear expectations for what good looks like; addresses performance gaps directly by ensuring team members understand what is expected and how to get there.
Coach Provides ongoing recognition and development feedback; helps team members find solutions to challenges and grow in their roles.
Connect Helps team members see their collective purpose and how their work connects to Centivos mission and broader organizational goals.
Customize Adapts leadership approach how to delegate coach communicate and support to the individual and the task at hand.
Centivo Values:
Resilient This is wicked hard. There is no easy button for healthcare affordability. Luckily the mission makes it worth it and sustains us when things are tough. Being resilient ensures we dont give up.
Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isnt working for members employers and providers. So were building it from scratch from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon.
Positive We care about each other. It takes energy to do hard stuff build something better and to be resilient and unconventional while doing it. Because of that we make sure we give kudos freely and feedback with care. When our tank gets low a team member is there to be a source of new energy. We celebrate together. We are supportive generous humble and positive.
Who we are:
Centivo is an innovative health plan for self-funded employers on a mission to bring affordable high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual) predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information visit .
Headquartered in Buffalo NY with offices in New York City and Buffalo Centivo is backed by leading healthcare and technology investors including a recent round of investment from Morgan Health a business unit of JPMorgan Chase & Co.
Required Experience:
Manager
About Company
Primary-care-centered self-funded health plans for employers of 50–3,000. Save ~15-30% vs. fully-insured. Serving WI, TX, FL, NY, WA, CT, PA, NC and more.