Job description

Key Responsibilities

Leadership:

• Oversees the Contact Center department and provides strategic direction and operational insight for CCA’s Medicaid/Medicare Dual Eligible enrollees and MAPD Plan members.
• Oversees Member Communications for all markets and all products. providing strategic direction and operational leadership.
• Serves as the business lead for program management efforts to ensure strategic alignment between customer service operations and enterprise-wide member experience strategic plans.
• Drives rapid and continuous improvement in the customer service experience, including the development of initiatives to improve customer service quality and ensure compliance with service level agreements.
• Aligns people, processes, and technology to identify appropriate communication strategies required to support customers and their unique needs.
• Works closely with the Chief Operating Officer to ensure service delivery work streams are coordinated, and stakeholders are updated on all key performance metrics.
• Works closely with the Chief Experience Officer to serve as a change leader – helping to educate, inform and influence all levels across the CCA organization to recognize the customer experience in all of our work and put our members at the center of everything we do.
• Builds collaborative working relationships throughout the organization in order to drive success and lead fundamental changes in our approach to customer service.
• Innovates and instills in his/her teams an appreciation for thinking outside of the box, questioning the status quo, and striving to find efficiencies in all work.
• Ensures compliance with contractual, regulatory, and corporate service level requirements, guidelines, and goals related to customer service performance.
• Tracks call and enrollment trends, makes decisions based on organized information, and supports decisions with articulate written and verbal communications.
• Utilizes Key Performance Indicators to prioritize improvements efforts.
• Leverages data, develops effective prescriptive analytics to inform decision-making, and shares pertinent data with stakeholders on performance for proactive response.
• Evaluates ongoing business opportunities and their impact on strategic growth, and leverages data to ensure scalability of operations.
• Leads the department in its quest to effectively engage employees and develop pathways for employee development.

Administrative Functions:

• Leadership for a team of 6+ managers and/or directors, with as many as 110+ overall staff, including performance management and ongoing development activities.
• Annual budgeting, budget to actual monitoring, and justification of budget variances.
• Provides business justification for capital and non-capital resource needs and supports various leaders with such requests when they have a direct impact on customer service facing operations.
• Drives technology evaluation activities in collaboration with the CIO to ensure state of the art innovations are deployed to improve the member experience.
• Specific Functional Oversight Responsibilities:

Member Contact Center

Provider Contact Center

Contact Center Training and Quality

Member Communications

Enterprise-wide Project Leadership (ad hoc)

Supervision Exercised:
Yes. Direct reports include the Directors of the Member and Provider Call Centers, Manager of Training, and Director of Member Communications.

Expectations for all employees:
Demonstrate integrity by working with passion, commitment, and honesty, acting in the best interests of colleagues and members. Approach work in a collaborating and caring manner interacting with insight, sincerity, and compassion. Demonstrate accountability by delivering on commitments, owning mistakes as well as successes, and contributing to an empowering environment where the focus is on solving problems and learning from errors. Recognize and respect diversity in all forms. Strive for excellence in the fulfillment of CCA’s mission through quality, innovation, and continuous learning. Demonstrate initiative, flexibility, and openness to change. Represent CCA and its clinical affiliates with professionalism. Keep current and proficient with necessary skills and knowledge. Self-identify training and development needs relevant to work area and responsibilities. Adhere to all applicable compliance requirements including but not limited to:

• Complete required compliance training in a timely manner
• Review Code of Conduct at least annually and promote and enforce CCA’s Code of Conduct
• Promote and enforce CCA’s compliance program
• Adhere to CCA’s Policy & Procedures
• Promptly, in good faith, report any instances of suspected fraud, waste, and abuse; suspected privacy and/or security incidents; or any compliance concerns identified

Ensure confidentiality of member and company proprietary information is maintained.

Minimum Education Required Bachelor's Degree or equivalent experience

Preferred Educational Experience BS / BA in business, health care or related field - advanced degree a plus.

Experience Required

• Minimum of 15+ years of progressive leadership with large scale change initiatives demonstrating success in systems development and deployment, including leading a diverse functional team / organization.
• Minimum of 10 years in one or more core operational functions, including call centers, enrollment functions, and appeals/grievances.

Knowledge, Skills and Abilities

• Knowledge of types of health care providers and their operations.
• Proven track record collaborating effectively cross-functionally with product management, operations and IT stakeholders.
• Ability to drive organizational change.
• Ability to think conceptually and effectively translate concepts into practical and executable plans.
• Business acumen to work with senior leadership and executives.
• Excellent communication (written, verbal and presentation) and organizational skills in deadline driven environment.
• Ability to be flexible and work with ambiguity.
• Strong communication skill sets, with the ability to present information in a variety of different formats to all levels of stakeholders.
• Strong analytical skills, with the ability to articulate and define outcome measures that capture key performance metrics.
• Excellent collaboration and relationship management skills.
• Demonstrated success in obtaining results in a corporate environment.
• Highly proficient with industry standard technologies.
• Ability to travel as required by the needs of the business.

Working

Conditions standard office environment

Equipment

Utilized standard office equipment

Language

Requirements English, bilingual preferred

Physical

Requirements Office position, sitting, walking, standing, bending, keyboard, mouse.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

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