Member Services Team Lead, Health Plan

Job Description

Location: Remote (US-based)

We are hiring for a Member Services Team Lead, Health Plan with a regional health plan managing commercial, Medicare Advantage, and Medicaid member services operations across multiple lines of business. This position is a full-time, direct hire opportunity.

Responsibilities

• Supervise day-to-day operations for an assigned team of member services representatives
• Monitor queue performance, adherence, and call quality in real time and intervene when needed
• Handle member escalations that require supervisor-level intervention or benefit exception review
• Conduct regular 1:1 coaching sessions with individual representatives focused on quality and compliance
• Lead daily team huddles covering plan updates, common call drivers, and quality focus areas
• Review QA scores and identify patterns that require coaching, retraining, or process correction
• Support new representative onboarding and training alongside the training team
• Communicate plan benefit changes, policy updates, and new procedures to the team
• Prepare and submit shift performance reports to the Member Services Manager

Qualifications

• Three or more years of member services, customer service, or benefits representative experience in a health plan or managed care setting
• One or more years of lead, senior, or supervisory experience preferred
• Working knowledge of Medicare Advantage, Medicaid, and commercial benefit structures
• Demonstrated ability to handle escalated member calls with professionalism and resolution focus
• Comfort with coaching staff on quality metrics in a direct, constructive manner
• Proficiency with call center workforce management and quality monitoring platforms
• Associate degree or higher preferred

Schedule

Fully remote within the US. Eight-hour shifts within an 8 AM to 7 PM EST operating window, Monday through Friday, with occasional Saturday coverage during open enrollment periods.

Salary Range: The salary range for this position is approximately $50,000 – $68,000 annually ($24.04 – $32.69 per hour), based on experience and qualifications.

Interview Process:

• Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with department leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and a diverse, inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.