Medicare Customer Service Manager (HH & H)

Role Snapshot

Our Medicare Customer Service Manager (HH & H) will lead a customer service team of roughly 20 members which includes 3 direct reports and focuses on delivering exceptional service. As a manager the primary role is to direct day-to-day operations, develop staff, and drive performance excellence through the implementation of strategic initiatives, policies, and procedures. Departmental expectations include ensuring compliance with CMS requirements, achieving Quality Assurance Surveillance Plan (QASP), Award Fee metrics, maintaining high levels of service accuracy, efficiency, and stakeholder satisfaction. This is a critical role that directly impacts our organization's success in meeting contractual obligations and maintaining a trusted partnership with CMS, while serving as a leadership anchor within the customer service department.

Salary Range

$85,000 ~ 110,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may foll outside of this range.

Work Location
We are open to remote work in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin

How do I know this opportunity is right for me? If you:

• Possess experience working with Medicare specifically in the Home Health and Hospice space.
• Have planned, organized, managed, and evaluated the day-to-day operations of a customer service team.
• Can ensure operational effectiveness and alignment with departmental priorities and service expectations.
• Excel at working in a highly compliant environment while complying with company policies and practices as well as CMS directives.
• Have maintain regulatory and contractual adherence through consistent oversight in previous roles.
• Would enjoy monitoring the performance of the department to ensure established goals and CMS requirements are met while tracking and responding to key performance indicators to ensure operational and quality targets are consistently achieved.
• Can partner with internal departments to share information, identify cause and effect, and implement methods to optimize performance levels.
• Like to collaborate with teams to make improvements and resolve systemic issues.
• Have developed, implemented, and continuously improve customer service processes to ensure operational efficiency.
• Enjoy building strong relationships with internal customers and CMS that foster trust, transparency, and open communication to support ongoing collaboration and alignment.
• Can ensure adherence to regulatory guidelines (i.e., HIPAA, CMS) when providing information and service to members and providers.

Minimum Qualifications

• Bachelor's Degree in related field or equivalent post high school and/or related work experience.
• 5 or more years of experience in customer service, claims processing, or outreach.
• 2 or more years of supervisory/team lead experience in Medicare Part A, Part B, or Home Health and Hospice operations.
• Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines.
• Excellent verbal and written communication skills with the ability to effectively explain complex information.
• Strong analytical, problem-solving, and organizational skills with the ability to manage multiple processes simultaneously and meet strict deadlines.
• Demonstrated leadership and team-building capabilities.
• Ability to identify, prioritize and drive work efforts that result in more efficient operations through innovation or process improvement.
• Ability to work in a complex, rapidly evolving environment with multiple internal and external stakeholders.
• Proficient in call center and workforce management technology tools such as CRM or OnBase.

Preferred Qualifications

• CMS knowledge of the Home Health and Hospice program.
• Knowledge of call center operations and workforce management technology tools.
• MAC contractor experience with FISS, MCS and CRM systems used for Home Health and Hospice.

Remote Work Requirements

• Wired (ethernet cable) internet connection from your router to your computer
• High speed cable or fiber internet
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net)
• Please review Remote Worker FAQs for additional information

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs
• Review additional benefits: (https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml)

Who We Are

WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.

Culture Drives Our Success

WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.

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