Customer Service Manager (Healthcare)

TL;DR

Customer Service Manager (Healthcare): Overseeing the provider-facing customer service operation for the SMRC to ensure accurate and timely communication with Medicare providers with an accent on SLA compliance and provider trust. Focus on managing daily operations, supervising staff, and coordinating with clinical teams to resolve complex provider inquiries.

Location: Remote (US)

Company

A data-centric healthcare transformation company focusing on quality data-driven solutions and clinical expertise to improve patient health outcomes.

What you will do

• Manage day-to-day operations of the SMRC provider customer service unit, ensuring full coverage during operational hours.
• Oversee all provider inquiry responses across phone, written, and portal-based communications.
• Handle complex inquiries regarding ADR letters, medical review determinations, and Medicare appeals processes.
• Supervise, train, and performance-manage customer service staff, including scheduling and material development.
• Track and report on performance metrics, including call volume, response timeliness, and resolution rates.
• Coordinate with clinical teams to ensure staff have current and accurate information on active review topics.

Requirements

• Bachelor’s degree in Business, Healthcare Administration, Communications, or a related field (or 4 additional years of related experience).
• Minimum 2 years of experience managing a customer service unit, including direct supervision of staff.
• Availability to work within the US time zone (8:30 AM to 6:00 PM ET).
• Experience handling Medicare provider inquiries is preferred.

Nice to have

• Prior experience at a CMS contractor (MAC, BFCC-QIO, RAC, SMRC, or similar).
• Experience managing call centers or provider relations teams under strict SLA requirements.
• Familiarity with Medicare provider communication standards and the administrative appeal process.

Culture & Benefits

• Fully remote work environment.
• Purpose-driven culture with straightforward communication and clinical domain expertise.
• Merit-based personnel processes and equal employment opportunity.