Director, Customer Care Operations

<h3>Accountabilities</h3><li>
<strong>Lead customer care operations:</strong>Oversee day-to-day operations through two Customer Care Managers and 12 Supervisors, with leadership accountability for approximately 150–200 pharmacy technicians and customer service agents supporting members, pharmacies, and clients.</li><li>
<strong>Drive operational performance:</strong>Establish service level, quality, efficiency, and member experience targets, monitor performance against goals, and hold leaders accountable for measurable operational results.</li><li>
<strong>Use data to improve outcomes:</strong>Analyze call trends, escalations, quality results, and operational metrics to identify root causes, prioritize improvement opportunities, and implement sustainable solutions.</li><li>
<strong>Manage workforce planning and operational budgets:</strong>Partner with Workforce Management and Operations leadership to forecast demand, optimize staffing and scheduling, plan capacity, and manage labor costs against budget and forecast.</li><li>
<strong>Deliver executive-level reporting:</strong>Prepare and present operational dashboards, performance insights, and business cases that support decisions about staffing, investment, resource allocation, and operating models.</li><li>
<strong>Optimize workflows and processes:</strong>Lead initiatives to reduce operational friction, eliminate unnecessary rework, improve first-contact resolution, and increase productivity across customer care functions.</li><li>
<strong>Maintain operational documentation:</strong>Oversee process documentation, job aids, workflow guidance, and knowledge management resources to ensure frontline teams have accurate, accessible, and consistent information.</li><li>
<strong>Lead escalations and issue resolution:</strong>Coordinate the investigation of complex service issues, identify underlying causes, align stakeholders, and ensure corrective actions address problems sustainably.</li><li>
<strong>Leverage technology and automation:</strong>Identify opportunities to improve service delivery through Salesforce CRM, Salesforce Knowledge, phone systems, the Member Portal, and other relevant technologies.</li><li>
<strong>Partner on policy and regulatory compliance:</strong>Collaborate with Policy, Compliance, and Legal teams to translate regulatory and legislative requirements into practical procedures, ensuring customer care operations remain aligned with applicable obligations.</li><li>
<strong>Strengthen quality assurance:</strong>Work with Quality Assurance and Compliance leaders to align quality standards and call evaluation criteria with operational priorities, using results to improve coaching, scorecards, and team performance.</li><li>
<strong>Support training and development:</strong>Partner with Training leaders to identify knowledge and skill gaps, shape training initiatives, and reinforce the adoption of new systems, processes, and service expectations.</li><li>
<strong>Maintain audit readiness:</strong>Ensure operational processes and documentation are prepared for audits and regulatory reviews, coordinating with Compliance and Legal to resolve corrective actions within established timelines.</li><li>
<strong>Develop managers and supervisors:</strong>Coach and mentor operational leaders, strengthen leadership capabilities, build succession depth, and foster a culture of accountability, engagement, and continuous improvement.</li><li>
<strong>Enhance performance management:</strong>Maintain and refine agent scorecards, quality measures, and performance management practices that support consistent coaching and fair, data-driven evaluations.</li><li>
<strong>Champion the frontline and member experience:</strong>Engage with frontline employees, review member feedback, and help teams understand changing service expectations, recurring issues, and process improvements.</li><li>
<strong>Lead strategic operational initiatives:</strong>Sponsor major projects, including new client and program launches, transitions, and operating-model changes, ensuring customer care readiness, scalability, and a positive frontline experience.</li><li>
<strong>Represent Customer Care across the organization:</strong>Partner with executive leadership, clients, and cross-functional teams to align operational priorities with broader business goals and contribute to strategic initiatives.</li><h2>Requirements</h2><li>
<strong>Education:</strong>Bachelor's degree in business, healthcare administration, or a related field, or an equivalent combination of education and professional experience.</li><li>
<strong>Extensive customer care leadership:</strong>At least 10 years of experience in call center or customer care operations, including seven or more years in leadership roles managing managers, multiple teams, or large operational organizations.</li><li>
<strong>Proven operational results:</strong>Demonstrated success improving service levels, quality, productivity, operational efficiency, and customer or member satisfaction through data-driven decision-making and process improvement.</li><li>
<strong>Cross-functional collaboration:</strong>Experience partnering with Quality Assurance, Training, Compliance, and Policy teams to translate business, regulatory, and service requirements into effective operational practices.</li><li>
<strong>People leadership and coaching:</strong>A strong track record of developing managers and supervisors, improving team performance, strengthening leadership capabilities, and building effective knowledge management practices.</li><li>
<strong>Analytical and business acumen:</strong>Strong analytical skills, with the ability to interpret operational data, identify trends, evaluate performance, and translate findings into actionable recommendations for senior leadership.</li><li>
<strong>Workforce management knowledge:</strong>An understanding of forecasting, staffing, scheduling, and capacity planning, with the ability to align resources with service demand and operational objectives.</li><li>
<strong>Process improvement expertise:</strong>Experience identifying inefficiencies, redesigning workflows, managing operational change, and implementing scalable solutions that improve service delivery.</li><li>
<strong>Technology proficiency:</strong>Proficiency with Microsoft 365 applications, including Outlook, Word, Excel, and PowerPoint, and familiarity with customer care systems and operational technology.</li><li>
<strong>Communication and stakeholder management:</strong>Excellent written and verbal communication, interpersonal, problem-solving, and conflict-resolution skills, with the ability to influence stakeholders across organizational levels.</li><li>
<strong>Customer-centric mindset:</strong>A strong commitment to member satisfaction and service recovery, including the ability to transform challenging customer interactions into positive experiences.</li><li>
<strong>Project and priority management:</strong>The ability to lead multiple projects simultaneously, meet deadlines, manage competing priorities, and maintain execution quality in a fast-paced environment.</li><li>
<strong>Integrity and accountability:</strong>Demonstrated professional integrity, sound judgment, and a commitment to ethical conduct, regulatory compliance, and responsible decision-making.</li><h2>Preferred qualifications:</h2><li>Experience in pharmacy operations, pharmacy benefits management, or health insurance operations.</li><li>Familiarity with process improvement, quality management, and project management methodologies such as Lean, Six Sigma, or PMP-based practices.</li><li>Hands-on experience with workforce management systems, forecasting models, and capacity planning.</li><li>Proficiency with Salesforce CRM, Salesforce Knowledge, contact center phone systems, and member-facing portals.</li><li>Knowledge of HIPAA and other healthcare regulatory requirements relevant to customer care operations.</li><li>Spanish language proficiency, particularly in environments serving diverse member populations.</li><li>A strong ability to build collaborative working relationships across business, technical, and operational teams.</li><h2>Benefits</h2><li>
<strong>Competitive compensation:</strong>Annual base salary ranging from<strong>$135,200 to $213,500</strong>, depending on experience, knowledge, skills, and work location.</li><li>
<strong>Remote work flexibility:</strong>A fully remote opportunity for candidates based in the United States.</li><li>
<strong>Leadership and professional development:</strong>The opportunity to lead a large customer care organization, develop future leaders, and shape scalable operational practices.</li><li>
<strong>Strategic business impact:</strong>The ability to influence service quality, operational efficiency, and the healthcare benefits experience for members, pharmacies, and clients.</li><li>
<strong>Technology-driven environment:</strong>Opportunities to improve customer care through modern platforms, knowledge management systems, process automation, and operational analytics.</li><li>
<strong>Cross-functional collaboration:</strong>Work closely with executive leadership and teams across Operations, Workforce Management, Quality Assurance, Training, Compliance, Policy, and Legal.</li><li>
<strong>Continuous improvement culture:</strong>Lead meaningful initiatives that strengthen service delivery, improve employee effectiveness, and support sustainable business growth.</li><li>
<strong>Equal opportunity workplace:</strong>Join an organization committed to providing equal employment opportunities and maintaining a professional environment free from discrimination and harassment.</li>