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Director, Service Solutions - Healthcare

St. Louis, MO · Healthcare
About the Company: 
A Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on underinsured and uninsured individuals.  Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans).  

The Company operates local health plans and offers a range of health insurance solutions.  It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

Position Overview:
Responsible for the development, implementation and management of initiatives to support health plan Member and Provider services and operations. Provide strategic direction to drive consistency and collaboration across the health plan call centers and other customer service channels. Lead the enterprise teams to drive process development and continuous improvement, as well as to steward the ongoing development of operational and self-service solutions.

  • Identify and implement strategies to maximize customer service performance; enhance the customer experience, increase flexibility, improve efficiency, mitigate risk, and optimize member and provider service experience
  • Develop, implement and manage programs centered on member satisfaction, training and quality
  • Initiate, design, and implement process improvement initiatives and analysis, department business development, and annual satisfaction initiatives
  • Manage all service related initiatives including identification of business need, strategy recommendation, project outline, management of deliverables, and ROI
  • Work collaboratively to facilitate the design, development and implementation of policies, procedures and practices related to call center / customer service operations
  • Implement new business initiatives including system design, implementation, and performance management
  • Coordinate with business partners to diagnose and resolve issues that will meet end user requirements
  • Develop and monitor performance reports to ensure compliance with company metrics and standards
  • Work collaboratively with technical support to manage operational systems and ensure reporting and metrics are viable
  • Oversee call center training development and delivery, call quality auditing and assessment
  • 10-20% travel required

  • Bachelor’s degree in business, information systems, operations or related field or equivalent experience.
  • 8+ years of customer service and operational management experience.
  • Experience in business requirement definition, training, project management, and system/process implementation.
  • Management consulting and health plan operations experience preferred
  • Experience with CRM applications, workforce management solutions, and web, chat, and mobile engagement channels preferred.

Licenses/Certifications: Current state driver’s license.

The company offers more than just medical insurance. They pay most of your benefits costs and in some cases – they pay 100 percent. Most of the benefits not covered by the company are paid with pre-tax payroll deductions. 
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Flexible spending accounts (includes health care, dependent care mass transit reimbursement)
  • Short- and long-term disability insurance
  • Basic Life insurance
  • Supplemental AD&D
  • Supplemental life insurance
  • Wellness Program
  • 401(k) retirement with company match
  • Employee stock purchase plan
  • Vacation, Personal and Sick time
  • Paid Company Holidays
  • Employee Assistance Program (EAP)
  • Training and Learning Opportunities
  • Tuition Reimbursement/Educational Assistance
  • Service Awards
  • On-site fitness center or discount at local fitness centers (most locations)
  • Discounts for select local and national products and services, including cell phones, computers and more
  • Other amenities may be available, but vary by location
Kat Forester
ProEnlist, LLC

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