Customer Service Supervisor (Healthcare)

Summary of Role

The Supervisor, Member Care, plays a critical role in delivering on Centivo's 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 Centivo's commitment to high-quality, personal support.

Responsibilities

• 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 Centivo's 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

• 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
• Associate's or bachelor's degree in a related field
• Familiarity with self-funded employer health plan structures and ERISA-governed benefit plans