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This role is responsible for direct management of the operations that support our Dual Special Needs Plan (DSNP) members.
They will have direct oversight to 1,200-1,500 FTE (across 6+ sites and WAH) by the end of the year. They will be responsible to oversee and guide performance management of DSNP operations, hiring / training / recruiting, creating a strong culture, employee development and ensuring a strong engagement amongst the workforce. The Operations Director will maintain a focus on continuous quality improvement and will manage through consistent application of data - informed decision making.
This leader will be responsible for managing an annual budget of $75M-$90M on behalf of our members and shareholders. With that, this role will have direct accountability to identify and execute on efficiency initiatives to allow us to provide better services across a wider population for less cost.
This leader will be responsible for providing executive updates and report outs to Executive Leadership from across Operations, Business units, and Finance. The leader will need to have a firm grasp of their business and operations, and will be expected to maintain awareness of and integration with broader initiatives across Benefit Operations and/or UHC/UHG. Leader will view decision making and management through the lenses of a growth mindset to ensure we are focused on differentiated service, scalability, sustainability, and membership expansion.
This position will require:
- Proven operational leadership ability and experience
- Ability to lead a large team
- Strong collaborative perspective and related professional network from which to garner support for daily projects and strategic initiatives
- Familiarity of workforce planning and real time workforce management
- Collaboration with leaders in the DSNP Care Coordination (DCC) program as well as other market and regional matrix partners to implement programs to support and meet business goals
- Driving ops transformation around agent metrics, skill development, process controls, capacity utilization, management and vision to effectively grow the organization
- Ability to positively foster a positive work environment and culture within a growing team (across many states / locations)
This role will be one of three directors in Complex Member Services Operations, accountable for leadership and operations management of multiple call center locations.
- Lead and develop a high-performance, consumer-centric management team and workforce
- Foster a culture of accountability that emphasizes people and performance management, coaching and development, and employee engagement
- Manage daily operations including multiple levels of staff and multiple services
- Mature outbound call capability model, including strategy, value-based reporting and staffing
- Analyze operational performance on relevant criteria (e.g., targeted financial metrics; quality indicators; performance guarantees
- Partner with relevant internal and / or external stakeholders to develop and / or review potential operational strategies, programs, and plans (e.g., affordability initiatives; quality programs; projected resource needs)
- Consistently achieve key performance metrics, including consumer satisfaction, compliance, employee engagement and financial objectives
- Ensure performance is tracked accurately utilizing internal tools and processes (e.g., dashboards; scorecards; reports) in order to facilitate performance review and analysis
- Conduct deep dive program reviews with relevant internal and / or external stakeholders to identify opportunities for continuous improvement
- Review, create, and / or maintain workflows to ensure they are up - to - date and operationally efficient
- Provide guidance, expertise, and / or assistance to internal and / or external partners (e.g., claims; call center; benefits; clinical) to ensure programs and strategies are implemented and maintained effectively
- Utilize stakeholder input to help shape and implement continuous improvement in operational quality and financial performance
- Build and foster relationships within a matrix organizational structure to proactively resolve issues, drive efficiencies and champion the consumerism strategy
- Monitor operational performance against internal and / or external service level agreements
- Understand and anticipate the behaviors and needs of consumers and customers. Collaborate with the vice president to develop strategies and tactics that simplify and improve the consumer experience and increase consumer and customer satisfaction and loyalty
- Proactively initiate and suggest changes in processes, tools and capabilities that increase operational efficiency and effectiveness while concurrently improving the consumer experience and comply with regulatory requirements
- Execute call center technology strategy to enhance the user interface and provide meaningful data to drive quality outcomes
- Leverage advanced analytics to drive targeted service strategies to improve quality outcomes (clinical, HEDIS, STARS, UES, CAHPS, etc.)
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.