Director, Member Services/Call Center Operations - The Health Plan

 
Position: Director, Member Services/Call Center Operations - The Health Plan

Job ID: 149555

Location: US-TX-Bellaire

Department: Member Services Admin

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p Monday - Friday

About Texas Children's Hospital

The Texas Children’s Hospital system is the largest pediatric integrated care system and is an industry leader in pediatric population health.    Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children and pregnant women.  We are an Integrated Community System providing holistic care that empowers families to live healthier lives.  Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.  Currently, the Health Plan serves more than 450,000 members across three state territories (Harris, Jefferson, North East), who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. To join our community of 13,000 dedicated team members, visit www.texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at www.infinitepassion.org

Summary:

We are searching for a Director of Member Services and Call Center Operations – someone who works well in a fast-paced managed care setting. In this position, you will develop and implement strategies that promote and ensure world-class customer service, oversee our mission control operations, as well as plan, organize, develop, direct, and manage all aspects of our member service and call center functions and staff. You will develop administrative strategies for educating members about the health plan benefits and services, along with their rights and responsibilities, and develop processes for delivering accurate information and assistance to providers.

 

Think you’ve got what it takes?



Responsibilities :

Job Duties & Responsibilities 

HOU123 

  • Provide leadership and strategic direction for the coordination and implementation of all aspects of our member services department, including mission control and all call center operations
  • Work closely with other leadership and departments to develop and implement integrated strategies and plans to address member and provider needs
  • Develop and administer a coordinated system of processes, technologies, and strategies that effectively integrate organizational resources and multiple channels of communications to influence customer interactions
  • Develop and execute annual operation plans such as staffing and retention, training, workload forecasting, performance standards and goals, budget development and management, disaster recovery and contingency planning, process and quality improvement initiatives, and optimization of technologies and support system
  • Provide leadership for the management of mission control and the call center by creating a team atmosphere that promotes employee empowerment and engagement, implementing strategies that support growth, and establishing clear goals for the department
  • Develop, monitor, and analyze reports and benchmarks to measure performance of member services and call center functions, which can include audits and trends performance results to enhance performance, identify pain points for our teams, and utilize improvement techniques and tools to elevate departmental performance
  • Manage customer relationships, gather and analyze customer satisfaction data, and develop best practices to manage and improve the customer experience
  • Serve as a liaison with external stakeholder groups, community outreach campaigns, other employees, et cetera

 



Qualifications:

Skills & Requirements 

 

  • Bachelor’s degree
  • Master’s degree in business administration, health care administration, or a related field preferred
  • 5 years’ experience in managed care
  • 4 years of formal management/superviosry experience
  • 2 years’ experience in call center setting
  • Knowledge of NCQA, HEIDIS, and JACHO standards, as well as knowledge of state and federal regulations applicable to health plans, HMOs, and government coverage programs
  • Excellent customer service skills required. Must possess the ability to communicate effectively with members/customers to assess needs, provide information or assistance, and resolve problems
  • Must have excellent written and verbal communication skills, the ability to interact with a wide variety of individuals and handle several complex situations simultaneously


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