Supervisor

Job Summary:The Director, Customer Care Medicare Support will lead strategic development, implementation, and oversight of initiatives designed to deliver world-class support and achieve 5-star ratings in annual MCAHPS surveys. This role will focus on aligning organizational goals with CMS, Medicare, and Medicare Star Ratings requirements, engaging internal and external stakeholders in designing and communicating strategies and outcomes to leaders throughout the organization. This role serves as a key senior leader within the call center and influences the member experience across our growing organization.Essential Functions: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 productsLead 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.Education and Experience:Bachelor's degree in business-related field requiredMaster's degree preferredEquivalent years of relevant work experience may be accepted in lieu of required educationTen (10) years of experience in a call center or similar environment is requiredFive (5) years of management experience, preferably call center management, is requiredMulti-site leadership/remote work experience preferredExperience in a call center and health insurance preferredStaffing and forecasting experience preferredLean Sigma/Continuous Improvement/Design Thinking experience preferredManaged care experience preferredCompetencies, Knowledge and Skills:Advanced knowledge of Microsoft Word, Excel, PowerPoint, and VisioStrong data analysis and trending skillsStrong project management skillsKnowledge of call center operations and trendsStrategic management skillsStrong negotiation skillsGood technical writing skillsStrong team and staff development skillsStrong collaboration and con

Created: 2025-12-05