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About the role
Key responsibilities & impact- Lead operational redesign and define business strategies that improve service performance, scalability, and operational efficiency across Customer Care.
- Establish and oversee integrated staffing models, cross-training strategies, and operational workflows across Customer Care, including PA Intake, specialized teams, and customer communications.
- Partner with IT leadership to ensure Customer Care systems and applications effectively support operations, analytics, and reporting, with ongoing evaluation to optimize performance and scalability.
- Serve as the accountable business owner for company customer and member experience initiatives, providing end-to-end leadership from strategy development and innovation through execution, adoption, and sustained results.
- Define performance standards, service metrics, and operating benchmarks to drive accountability and consistently exceed service-level expectations.
- Establish strong cross-functional working relationships between Customer Success, Clinical Services, Technical Operations, and Government Programs, Sales and Implementation departments to ensure seamless service delivery and client onboarding.
- Provide strategic oversight of Customer Care workforce planning, forecasting, and capacity modeling by analyzing demand trends, developing forecasts, researching business requirements, workflow design, and business growth requirements.
- Lead forward-looking strategy and the adoption of innovative methodologies to continuously enhance call center capabilities, operational performance, and technology advancement.
- Drive a culture of continuous operational improvements focused on enhancing customer experience, operational effectiveness, and quality outcomes.
- Set strategic direction for associate training, leadership development, and call center certification to ensure workforce readiness and performance excellence.
- Evaluate emerging technologies, systems, and sourcing strategies to strengthen Customer Care capabilities and improve serve delivery.
- Oversee the development, implementation, and governance of Customer care policies, procedures, and quality frameworks, including performance monitoring and corrective action.
- Ensure robust tracking, trending, and reporting of operational metrics, performance guarantees, and service outcomes.
- Provide oversight of accreditation, including application preparation, compliance maintenance of necessary documentation to demonstrate compliance with accreditation standards and coordination of on-site reviews.
- Other duties as assigned.
Requirements
What you’ll need- Bachelor’s degree in Business or related field, or equivalent work experience required.
- 10+ years of progressive leadership experience overseeing large-scale, multi-channel call center or customer care operations, including accountability for performance, staffing, and service outcomes required.
- 10+ years of progressive management experience within a managed care, PBM, or comparable highly regulated health care environment, with demonstrated responsibility for complex operations and cross-functional coordination required.
- Proven record of operational leadership resulting in measurable improvements in efficiency, productivity, capacity utilization, and service performance through process redesign, workforce optimization, and performance management required.
- Demonstrated experience implementing operational and technology improvements within call center environments, including adoption of new methodologies that enhanced efficiency, customer experience metrics, and overall performance required.
- Participate in, adhere to, and support compliance program objectives.
- The ability to consistently interact cooperatively and respectfully with other employees.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
operational redesignbusiness strategiesstaffing modelscross-training strategiesperformance standardsservice metricscapacity modelingworkflow designcall center certificationcompliance maintenance
Soft Skills
leadershipcross-functional collaborationstrategic oversightcontinuous improvementcommunicationinterpersonal skillsaccountabilityinnovationcooperationrespectfulness
Certifications
Bachelor’s degree in Businesscall center certification