Director, Customer Care Medicare Support(Preferred Experience In Medicare Contac

• Develop and manage a multiyear roadmap for Star ratings improvement for all Medicare contracts and lines of business. Translate business strategy into actionable business requirements.
• Ensure alignment with the organization’s short and long-term goals for performance improvement and quality.
• Establish clear performance goals and metrics for Star rating and quality measures. Provide oversight of the measurement, tracking, and reporting of key quality performance indicators (Part C and Part D) to ensure alignment with CMS regulations and organizational goals.
• Ensure integration of Star ratings strategy with organizational objectives. Partner with clinical, operational, and network teams to develop action plans for addressing Star metrics which can be influenced by Customer Care.
• Lead root cause analysis for underperforming measures using industry standard methodologies. Regularly engage with leaders across the organization (Market; Operations; Clinical) to provide insight into opportunities.
• Design Member/Provider Experience service process and ensuring the continuous improvement of service experience across markets and products
• Lead a team of Customer Care Managers, Team Leaders in building a High-Performance Culture – goal/expectation setting, defining Reward & Recognition Programs, identifying ongoing Training Needs and driving focus on Personal Accountability.
• Monitor all regulatory requirements and oversight of all submissions in existing and future lines of business.
• Deliver recommendations related to improvements to Self-Service tools (IVR, Digital Products etc.) based on Top Contact Types.
• Perform continuous review and improvement of business process workflow.
• Facilitate/promote problem identification, analysis, and resolution across the organization to improve member/provider experience.
• Utilize formal and informal meetings to gather information and provide feedback and developmental ideas to staff members.
• Analyze data and identify trends monthly to ensure company expectations are met.
• Identify information system inefficiencies and formulate recommendations.
• Keep abreast of new call center technology and service concepts.
• Performs any other job related duties as requested.

• Bachelor's degree in business-related field required
• Master's degree preferred
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Ten (10) years of experience in a call center or similar environment is required
• Five (5) years of management experience, preferably call center management, is required
• Multi-site leadership/remote work experience preferred
• Experience in a call center and health insurance preferred
• Staffing and forecasting experience preferred
• Lean Sigma/Continuous Improvement/Design Thinking experience preferred
• Managed care experience preferred

• Advanced knowledge of Microsoft Word, Excel, PowerPoint, and Visio
• Strong data analysis and trending skills
• Strong project management skills
• Knowledge of call center operations and trends
• Strategic management skills
• Strong negotiation skills
• Good technical writing skills
• Strong team and staff development skills
• Strong collaboration and conflict resolution skill sets
• Proven leadership with the ability to build relationships/collaborate and influence at all levels
• Strong process and analytical skills with the ability to articulate and define outcome measures that capture key performance metrics
• Ability to work in a fast-past environment
• Attention to detail
• Ability to develop, prioritize and accomplish goals/time management
• Executive management skills
• Strong decision making and problem-solving skills
• Exceptional communication skills (both written and verbal) with the ability to present information in a variety of different formats to all levels
• Strong interpersonal skills and high level of professionalism
• Ability to work independently and within a team environment
• Effective active listening and critical thinking skills

• None

• General office environment; may be required to sit or stand for extended periods of time
• Ability to travel as required by the needs of the department.

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.