Oversight of high visibility, Operational Excellence / Customer Experience projects and processes such as HMO City Gold and the Medicare Loyalty team designed to enhance customer experience and increase customer loyalty. Responsible for the day to day operations and performance of the Albany and Syracuse PPO Customer Service centers; serve as Albany Customer Service Center site Leader. Oversight of CCI Customer Service function: ensure operational efficiency and maximization of customer satisfaction. Partner with other Operations leadership to address issues that impede performance (i.e., communications, process related, training, etc.) to ensure our members and providers are given the best service possible. Work with AVP, Workforce Management & Reporting to ensure that service levels are achieved for Quality and Service; and to identify and address opportunities for process and performance improvement. Develop recommendations that drive operational excellence and customer loyalty objectives. Apply Change Leadership at all times to influence effective business decisions and outcomes.
Day to day leadership of all EmblemHealth and CCI Call Centers, consisting of multiple sites and more than 150 FTEs:
Provide direction to the Call Center Directors to ensure proper alignment of resources and to ensure that corporate goals are obtained.
Facilitate the alignment of systems and processes with corporate business goals. Partner with Account Directors, Business Owners and IT Information Architecture and Application Development functions to facilitate implementation of technological solutions for end-to-end core processes as needed.
Provide technical expertise and recommendations to senior and middle management for identifying, planning, and implementing solutions to resolve ad-hoc business issues.
Facilitate implementation of recommendations.
Develop and implement strategies to improve customer service and retention.
Lead large-scale, end-to-end, cross-functional projects with a specific emphasis on driving results for Operational Excellence and Consumer Experience initiatives.
Apply Voice of the Customer and business data to scope the level of improvement required to impact customer loyalty and bottom-line results.
Partner with senior and line management to facilitate implementation of recommendations.
Create and implement automated solutions to increase productivity, accuracy and to make improvements in workflow.
Responsible for: development and management of direct reports to achieve pre-established Customer and Corporate goals; effective and efficient resource allocation based on business needs; resource management and real time adjustment of resources.
Build relationships with internal groups such as HR, IT, QA and training.
Evaluate core business processes to leverage opportunities for operational improvements; work with workforce management and reporting to define/identify/respond to trends, root causes and customer centric metrics.
Review reports that are distributed to EmblemHealth Leadership and Operational teams.
Participate in evaluation of IVR technology and be heavily involved in the rollout of the new technology
Mentor and train cross-functional teams on Lean, Six Sigma, Process Management and Change Leadership techniques as needed to facilitate project movement.
Provide clear communication and collaboration between key areas to include Claims, IT, EPMO, Provider Network, Management, QA and Training in an effort to develop and implement customer focused business solutions.
Regular review of departmental policies and procedures to ensure alignment of work and expected results.
Provide clear communication of business priorities to leadership and staff with regular progress reports delivered to those involved.
Bachelor's Degree, preferably in healthcare, operations, business or related discipline, master's preferred
Lean Six Sigma Black Belt or Lean Master Certification preferred
10 12 years' related business experience required
7+ years in process improvement/re-engineering (i.e., Supply Chain Management, Business Process Management, Industrial Engineering, etc.) required
3 - 5 years' experience in operations, including management of call center(s) required
5 years' experience in positions designed to drive business performance improvement on a full time basis required
Minimum 1 year of relevant experience post certification preferred, or
Additional years of experience may be used in lieu of educational requirement required
Experience leading large scale operations (enterprise or large division/department level) required
We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.
Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.