Supervisor, Concierge Member Services

Summary

The Concierge Member Services Supervisor is responsible for leading, coaching, and managing a team of Concierge Member Services Representatives (CMSRs) to ensure delivery of high-quality, compliant, and member-centered service experiences. This role oversees daily operations for inbound and outbound member interactions, ensures performance objectives are met, and partners closely with leadership and cross-functional teams to drive continuous improvement, CAHPS performance, member satisfaction, retention, quality, and STAR initiatives.

• Supervise, coach, and develop a team of CMSRs to achieve individual and team performance goals.
• Serve as the first point of escalation for complex member issues, service recovery, and CMSR support needs.
• Monitor real-time operations to ensure adequate coverage, productivity, and adherence to service level targets.
• Foster a positive, accountable, and member-first team culture aligned with organizational values.

• Ensure team members consistently meet or exceed performance metrics, including call handling, quality, caller satisfaction, CAHPS-related measures, and STAR score initiatives.
• Conduct regular call monitoring, audits, and quality reviews, ensuring team audit scores meet or exceed established targets (e.g., 95% rolling average where applicable).
• Deliver timely, constructive feedback, coaching, and corrective actions as needed to drive performance improvement.
• Identify performance trends and proactively elevate risks or improvement opportunities to leadership.

• Oversee inbound and outbound member campaigns including reporting, scripts, queues, and dialer files, ensuring alignment with organizational objectives and regulatory requirements.
• Ensure CMSRs provide accurate, timely, and compliant information related to onboarding, benefits, enrollment/disenrollment, provider access, claims, and coverage.
• Support end-to-end member service resolution, including appointment scheduling, ride coordination, pharmacy preferences, follow‑up care, and value-based care coordination.
• Ensure in‑network provider availability for scheduling and oversee processes to add or activate providers in applicable systems.

• Analyze recurring member issues, CMSR feedback, and performance data to identify process gaps and improvement opportunities.
• Partner with Operations, Sales, Network, Quality, Customer Relations, and other departments to resolve systemic issues and improve member experience.
• Provide actionable service improvement recommendations to leadership based on team insights and member interactions.
• Support special projects, pilot programs, and initiatives tied to member experience, quality, and organizational priorities.

• Assist with onboarding, training, and mentoring of new CMSRs.
• Participate in workforce planning, scheduling, and staffing discussions.
• Support change management initiatives and effectively communicate updates to the team.
• Policy creation.

• High school GED
• 5+ years of customer service experience, preferably with 3+ years in a call center or member services environment
• 2+ years of demonstrated leadership or supervisory experience
• Proven proficiency in Microsoft suite including Outlook, Word, and Excel

• 2+ years in health insurance
• 2+ years in Medicare or managed care environment
• Experience supporting CAHPS, quality, or STAR-related initiatives

Member Services is the frontline of member interaction, resolving concerns, answering questions, and providing assistance with empathy and efficiency. Exceptional customer service fosters member trust and satisfaction, encourages loyalty and retention, and streamlines processes to boost overall organizational productivity. Measurable impact includes improved retention rates, higher CAHPS and NPS scores, reduced voluntary disenrollment, and increased member engagement with preventive and supplemental benefits.

Member Success drives…