Member Services Manager

2 days ago

Makati City, National Capital Region, Philippines Inova Care USA Full time ₱700,000 - ₱800,000 per year

Department: Operations / Member Services

Reports To: VP of Operations

Location: Makati

Employment Type: Full-Time

Job Summary

The Member Services Manager is responsible for overseeing the delivery of exceptional service to health plan members, ensuring timely resolution of inquiries, claims, and benefit-related concerns. This role leads a team of customer service professionals, drives process improvements, and ensures compliance with service-level agreements (SLAs) and regulatory standards. The ideal candidate is a strategic thinker with strong leadership skills and a passion for member advocacy.

Key Responsibilities

  • Lead and manage the Member Services team to ensure high-quality service delivery across all channels (phone, email, chat)
  • Monitor daily operations and ensure adherence to SLAs, KPIs, and quality standards
  • Develop and implement member engagement strategies to improve satisfaction and retention
  • Handle escalated member issues with professionalism and empathy, ensuring timely resolution
  • Collaborate with Claims, Provider Relations, and IT teams to streamline workflows and resolve cross-functional issues
  • Analyze service trends and member feedback to identify areas for improvement
  • Prepare and present regular performance reports to senior management
  • Conduct training, coaching, and performance evaluations for team members
  • Ensure compliance with data privacy, healthcare regulations, and internal policies

Qualifications

  • Required: Singapore Certifications on: BCP, PGI and HI
  • Bachelor's degree in Healthcare Administration, Business, or related field (Master's preferred)
  • Minimum 5 years of experience in customer service or member services, preferably in healthcare, TPA or insurance
  • Proven leadership experience managing service teams in a high-volume environment
  • Strong knowledge of healthcare benefits, claims processes, and regulatory requirements
  • Excellent communication, conflict resolution, and interpersonal skills
  • Ability to analyze data and make strategic decisions based on insights

Job Type: Full-time

Pay: Php70, Php80,000.00 per month

Work Location: In person

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