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Customer Service Director

Health Plan of San Joaquin

Customer Service Director

Modesto, CA
Full Time
Paid
  • Responsibilities

    The Director of Customer Service is responsible for delivering world-class highly member-centric support through operational excellence solutions. Collaborate closely with revenue leaders and service delivery vertical leaders to drive continuous improvement and scale the customer service function by automating service functions in the app along with operating an agile customer contact center. Act only with the customer’s best intentions in mind and hold their trust in the highest regard. The Director of Customer Service acts as the utmost subject matter expert and authority on customer service for the business unit and runs the daily operations of the business unit’s customer contact center.

     

    We’re looking for a compassionate and analytical go-getter to take a leadership role in our Customer Service team. This is an exceptional opportunity to manage a team with an inspiring mission. You will get the opportunity to interact with other teams in the organization, while managing the Customer Service team and delivering delightful customer service to our members. The ideal candidate is positive, motivated, dynamic, thoughtful, analytical, creative, enthusiastic and resilient with excellent judgment.

     

     

    Required Skills

    • In-depth knowledge of industry customer experience and customer service best practices and trends.
    • In-depth knowledge of call center best practices, including software systems, service standards and metrics.
    • In-depth knowledge of health care delivery systems, including managed care, as they relate to call centers and customer service.
    • In-depth knowledge of regulatory guidelines as they relate to call centers and customer contact, customer service, cultural and linguistic services and the member grievance/appeal process.
    • In-depth knowledge of the business, economic, demographic and political trends and developments affecting healthcare and managed care in general.
    • In-depth knowledge of general medical policy benefits and exclusions, and industry standard payment practices.
    • Basic knowledge of provider contracts, contract types and reimbursement models.
    • Financial acumen: Interprets and applies understanding of key financial indicators to make better business decisions.
    • Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
    • Decision quality: Makes good and timely decisions that keep the organization moving forward.
    • Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies.
    • Ability to create, execute and monitor relevant strategic and business plans.
    • Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.
    • Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.
    • Ensures accountability: Holds self and others accountable to meet commitments.
    • Drives results: Consistently achieves results, even under tough circumstances.
    • Demonstrated ability to develop and manage realistic budgets.
    • Very strong oral and written communication skills with the ability to communicate professionally, effectively and persuasively to diverse individuals and groups inside and outside of HPSJ.
    • Very strong interpersonal skills with the ability to establish and maintain effective working relationships with individuals at all levels both inside and outside of HPSJ
    • Very strong collaboration skills with demonstrated ability to create and foster a collaborative work environment, maintain effective, high performance teams, and organize people and resources to solve problems and identify business opportunities.
    • Very strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.
    • Builds networks: Effectively builds formal and informal relationship networks inside and outside of the organization.
    • Organizational savvy: Maneuvers comfortably through complex policy, process and people-related organizational dynamics.
    • Persuades: Uses compelling arguments to gain the support and commitment of others.
    • Manages ambiguity: Operates effectively, even when things are not certain or the way forward is not clear.
    • Strong project management skills, including the ability to manage organizational-wide projects to successful conclusion.
    • Strong knowledge of change management theory, with ability to anticipate and implement effectively.
    • Promotes and maintains, and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.
    • Ability to supervise staff in a manner that maximizes employee performance and business results, with very strong coaching/counseling skills, including the ability to function as a mentor.
    • Very strong customer service skills.
    • Intermediate skills in Word, Excel, PowerPoint and Outlook.
    • Ability to speak and be understood in English.
    • Ability to handle confidential information with appropriate discretion.

    Required Experience

    • Bachelor’s Degree in Business, Public Administration or related; and
    • At least five years customer service management in a health plan or healthcare organization; and
    • At least two years’ experience working with Medi-Cal or other state or federally sponsored programs; and
    • At least two years working in managed care; or
    • Equivalent combination of education and experience.

     

    Preferred

    • Bilingual

     

    LICENSE, CERTIFICATION, REGISTRATION

    • Valid California driver license and reliable transportation or, the ability to obtain transportation on demand in the counties served by HPSJ if prohibited from getting a driver license due to a medically documented disability.
  • Qualifications
    • In-depth knowledge of industry customer experience and customer service best practices and trends.
    • In-depth knowledge of call center best practices, including software systems, service standards and metrics.
    • In-depth knowledge of health care delivery systems, including managed care, as they relate to call centers and customer service.
    • In-depth knowledge of regulatory guidelines as they relate to call centers and customer contact, customer service, cultural and linguistic services and the member grievance/appeal process.
    • In-depth knowledge of the business, economic, demographic and political trends and developments affecting healthcare and managed care in general.
    • In-depth knowledge of general medical policy benefits and exclusions, and industry standard payment practices.
    • Basic knowledge of provider contracts, contract types and reimbursement models.
    • Financial acumen: Interprets and applies understanding of key financial indicators to make better business decisions.
    • Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
    • Decision quality: Makes good and timely decisions that keep the organization moving forward.
    • Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies.
    • Ability to create, execute and monitor relevant strategic and business plans.
    • Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.
    • Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.
    • Ensures accountability: Holds self and others accountable to meet commitments.
    • Drives results: Consistently achieves results, even under tough circumstances.
    • Demonstrated ability to develop and manage realistic budgets.
    • Very strong oral and written communication skills with the ability to communicate professionally, effectively and persuasively to diverse individuals and groups inside and outside of HPSJ.
    • Very strong interpersonal skills with the ability to establish and maintain effective working relationships with individuals at all levels both inside and outside of HPSJ
    • Very strong collaboration skills with demonstrated ability to create and foster a collaborative work environment, maintain effective, high performance teams, and organize people and resources to solve problems and identify business opportunities.
    • Very strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.
    • Builds networks: Effectively builds formal and informal relationship networks inside and outside of the organization.
    • Organizational savvy: Maneuvers comfortably through complex policy, process and people-related organizational dynamics.
    • Persuades: Uses compelling arguments to gain the support and commitment of others.
    • Manages ambiguity: Operates effectively, even when things are not certain or the way forward is not clear.
    • Strong project management skills, including the ability to manage organizational-wide projects to successful conclusion.
    • Strong knowledge of change management theory, with ability to anticipate and implement effectively.
    • Promotes and maintains, and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.
    • Ability to supervise staff in a manner that maximizes employee performance and business results, with very strong coaching/counseling skills, including the ability to function as a mentor.
    • Very strong customer service skills.
    • Intermediate skills in Word, Excel, PowerPoint and Outlook.
    • Ability to speak and be understood in English.
    • Ability to handle confidential information with appropriate discretion.