Director, Customer Care Center Needed in Boston

Our Client, located in Boston, is currently seeking an experienced, highly skilled Director, Customer Care Center. The Director is responsible for leading the development, management and continuous improvement of our Center to achieve service excellence, operational excellence, and regulatory compliance. The Director shall help formulate, develop and execute the operational plan that achieves corporate vision for service excellence.

The Director shall be responsible for building, leading and managing highly motivated, effective teams to deliver excellent service to our customer base including Members, Providers, and Sponsors. The Director will be expected to utilize industry-standard operational metrics to continually benchmark performance against other like service organizations, internal and external. 

The Director shall be an active participant in several Operations Committees, and other project teams and committees as necessary.
Primary Responsibilities:

•Provide leadership for the Customer Care Center ensuring that all service level expectations are achieved. 
•In collaboration with the VP of Operations, develop overall Call Center metrics that enhance first point-of-contact resolutions. Continuously assess whether current metrics are accurately reflecting customer preferences and needs. 
•Manage all assigned staff. 
•Ensure organization compliance with regulatory standards. 
•Work closely with Clinical, Quality and Compliance, Provider Network Management, Claims, Enrollment, Sales, and other departments to ensure an accurate and consistent understanding of member policies and procedures. 
•Work collaboratively with other departments to represent member feedback and opinions obtained through analysis, member satisfaction surveys and member appeals data with the goal of strengthening our brand through the development of service improvement initiatives designed to increase satisfaction. 
•Work collaboratively with Sales, Corporate Communication, Clinical, and Quality and Compliance to define, implement and measure outreach and education programs. 
•Develop criteria designed to empower frontline staff to deliver quality service to our members and ensure criteria support policies. 
•Ensure effective and accurate measurement and reporting for the overall performance of Call Center activities. 
•Ensure process and education is in place to allow staff to appropriately resolve calls at a broad and specific level. 
•Ensure that all contractual requirements are met with respect to the Customer Care Center. 
•Create and manage departmental budget and meet financial targets. 
•Track and report on key Member and Provider trends as required. 
•Lead and participate in key initiatives, such as new product development initiatives. 
•Ensure departmental compliance with HIPAA privacy regulations. Provide leadership to ensure member information is kept confidential through verification, access and restriction of information when appropriate. 

Job Requirements 

Preferred Qualifications: •BA/BS required; Master's degree preferred. 
•8-10 years of related job experience in a high volume call center including managing staff and supervising managers/supervisors. 
•Must have current working knowledge of Call Center metrics, best practices and relevant technologies. 
•Proven senior level leadership skills in a managed care environment experience working with Medicaid and other governmental and commercial products. 
•Knowledge of business and managed care environment issues that relate to consumer choice. 
•Demonstrated ability to build effective work teams and measure their effectiveness through performance metrics. 
•Working knowledge of claims processing and enrollment operations. 
•Exceptional communication skills. 
•Demonstrated ability to work collaboratively to achieve organizational goals.
•Demonstrated ability to deliver results in environments with shifting priorities. 
•Demonstrated ability to design, deliver and evaluate consumer retention strategies and programs. 
•Knowledge of Federal and State mandated benefit and other requirements. 
•Project management skills.

$100K

LaVerne Freeman
laverne_f@yahoo.com