Member Services Processing Supervisor

Member Services Processing Supervisor

We are seeking a Member Services Processing Supervisor to support Third-Party Administrator (TPA) healthcare operations for a limited benefit healthcare program. The Member Services Processing Supervisor oversees daily operations related to the intake, analysis, and processing of member applications and supporting workflows, documentation, and service requests. This role ensures that high-volume workflows are completed accurately, efficiently, and in alignment with program requirements, federal regulations, and quality standards. The supervisor provides hands-on support to processing staff, monitors performance, ensures adherence to internal procedures, and helps maintain a consistent, high-quality member experience across all processing activities.

Responsibilities:

• Lead and supervise a team responsible for processing and customer service related to enrollment applications, certifications, transfers, and documentation, ensuring accuracy, compliance, and timely completion.
• Provide day-to-day oversight of work assignments, productivity monitoring, and performance coaching.
• Manage inbound and outbound communication related to member documentation and processing activities, ensuring sensitive information (PII/PHI) is handled in accordance with HIPAA and program guidelines.
• Train and mentor staff on policies, tools, systems, and regulatory requirements to ensure consistent and compliant processing operations.
• Review completed work for quality and completeness, identifying trends, gaps, or training needs.
• Interview prospective candidates and provide hiring recommendations for processing staff, maintain attendance records and support employee administration in an accurate and timely fashion. Collaborate with Member Services leadership and cross-functional operational teams to improve processes, streamline workflows, and maintain alignment with program objectives.
• Use member services tools and systems-such as digital mail centers, self-service portals, and intake/IDP tools-to support efficient workflow execution and issue resolution.
• Escalate complex cases, data irregularities, or regulatory concerns to appropriate program or operational stakeholders.
• Track and report processing metrics, contributing to operational dashboards and program visibility needs.
• Support dual-operations or transition activities as required by program shifts or implementation phases.

Required Qualifications:

• High School Diploma or equivalent
• 3 or more years of relevant experience.
• Experience supervising processing, administrative, customer service, or operations teams in a high-volume environment.
• Strong knowledge of data entry, documentation review, and workflow management.
• Familiarity with federal program requirements, eligibility standards, regulatory compliance, or similar frameworks.
• Excellent written and verbal communication skills, with the ability to coach staff and coordinate with internal and external stakeholders.
• Strong attention to detail and commitment to accuracy and compliance.
• Proficiency with standard operational software, member service tools, and case-handling systems.
• Ability to handle sensitive information securely and professionally.
• Location: Remote Clearance: Public Trust Travel: 0-10%

Preferred Qualifications:

• Background supporting federal health programs or healthcare operations.
• Experience working with intelligent document processing tools, member service portals, or customer support platforms such as ServiceNow or CXone.

GDIT IS YOUR PLACE :

• Full-flex work week to own your priorities at work and at home.
• 401K with company match.
• Comprehensive health and wellness packages.
• Internal mobility team dedicated to helping you own your career.
• Professional growth opportunities including paid education and certifications.
• Cutting-edge technology you can learn from.
• Rest and recharge with paid vacation and holidays.