Director Customer Service

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

· Strive to apply an equity lens to all our work.

· Reduce health disparities.

· Become an anti-racist organization.

· Create an equitable work environment.

About the Role

The primary focus is to oversee all aspects of CHPW’s Customer Service and ensure delivery of exceptional customer service to members, healthcare providers, and other stakeholders. This role plays a vital role in maintaining customer satisfaction and enhancing the overall experience. Manages team of CS Managers and Trainers.

To be successful in this role, you:

• Are committed to the advancement of diversity, equity, and inclusion within CHPW.
• Have minimum of seven (7) years of experience leading customer service delivery in a call center environment required.
• Possess health insurance experience with Government programs such as Medicaid, Medicare Advantage Plans and Exchange products.
• Have a solid background and knowledge in the call center environment that will guide you to make effective decisions and changes in real time to meet the requirements and call volume.
• Have experience in creating a clear and inspirational vision and strategy for your teams.
• Have experience managing and mentoring people leaders, and ensuring they have the tools and resources to run a successful department.

Essential functions and Roles and Responsibilities:

• Oversee all aspects of the customer service department, including call center operations, system implementations, and personnel management.
• Collaborate with the Vice President of Customer Experience to develop and implement strategic activities which align with the objectives of the organization, develop tactical plans, drive performance, and achieve targets.
• Manage a team of Customer Service leaders, providing guidance, mentorship, and fostering a collaborative work environment, to ensure their success and professional development.
• Stay updated on industry trends and best practices to continuously improve our customer service operations.
• Management of resource decision-making and planning, and budget adherence.
• Represent CHPW Customer Service in external workgroups with regulators, community-based organizations our community health centers.
• Hold customer service leadership accountable for meeting performance expectations and adhering to company policies and procedures.
• Act as a lead in committees focused on enhancement of our health plan service and quality ratings.
• Work with other senior leaders to ensure potential impacts to the call center are considered when designing new materials, communications, and outreach campaigns.
• Responsible for representing the CS department in regulatory audits with the Center for Medicaid and Medicare Services (CMS), the Health Care Authority (HCA) and the National Committee for Quality Assurance (NCQA.
• Lead and participates in departmental and interdepartmental workgroups to continually enhance the delivery of programs and services, and proactively respond to changing client and market expectations.
• Responsible for oversight of Customer Service performance dashboards; Report monthly to the Compliance department, the CMS Plan Manager, and quarterly to the Board of Directors, Compliance Committee, and the Quality Council.
• Establish, measure, and set metrics for customer service and operational quality, including customer satisfaction targets; collaborate with CS Leadership to ensure consistent achievement of these targets.
• Champion the voice of the customer within the organization, advocating for changes and improvements based on customer feedback and insights.
• Make recommendations for technology investments and resource allocation to support the evolving needs of the organization.
• Responsible for system and application development, implementation, and enhancements.
• Oversight of recruitment, onboarding, and talent acquisition to ensure a skilled, diverse workforce aligned with organizational goals.
• Directs the development and implementation of training programs for Customer Service constantly looking for ways to maximize efficiency and effectiveness of learning activities.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

• Ability to communicate customer issues in a meaningful way to both technical and business audiences at various levels of seniority.
• Ability to set performance expectations, coach for performance success, achieve department and company objectives, and demonstrate proficiency in all aspects of employee supervision, including hiring, performance management, and coaching.
• Expertise in process improvement and implementing best practices.
• Knowledge of agency, state and federal regulatory requirements and guidelines that impact the customer service department.
• Knowledge of call center phone systems, scheduling software, and statistical reporting.
• Ability to develop and analyze various types of reporting; perform projections for staffing and budgeting; manage projects with analysis and reporting.
• Skilled in utilizing Microsoft Office applications such as Outlook, Excel, PowerPoint, and Word.
• Ability to create reports, analyze data and present verbally, or in written form to stakeholders.
• Ability to present in front of a variety of audiences.
• Excellent communication and interpersonal skills, with the ability to interact with individuals at all levels.
• Organizational, time management, and project management skills.

As part of our hiring process, the following criteria must be met:

• Complete and successfully pass a criminal background check.

Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
• Vaccination requirement (CHPW offers a process for medical or religious exemptions)
• Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Exempt and is not eligible for overtime. Based on market data, this position grade is 71 and has a 15% annual incentive target based on company, department, and individual performance goals.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

• Medical, Prescription, Dental, and Vision
• Telehealth app
• Flexible Spending Accounts, Health Savings Accounts
• Basic Life AD&D, Short and Long-Term Disability
• Voluntary Life, Critical Care, and Long-Term Care Insurance
• 401(k) Retirement and generous employer match
• Employee Assistance Program and Mental Fitness app
• Financial Coaching, Identity Theft Protection
• Time off including PTO accrual starting at 17 days per year.
• 40 hours Community Service volunteer time
• 10 standard holidays, 2 floating holidays
• Compassion time off, jury duty

Sensory/Physical/Mental Requirements:

Sensory*:

• Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical*:

• Extended periods of sitting, computer use, talking and possibly standing
• Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion
• Frequent torso/back static position; occasional stooping, bending, and twisting.

Mental:

• Frequent decision-making. Ability to gather and assess data, determine appropriate actions, apply protocols and knowledge to unique situations, problem-solve and provide consultation.

Work Environment:

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.