Director of Member Experience
hace 2 días
Kennesaw
Location: 1701 Barrett Lakes Blvd, St 150, Kennesaw, GA 30144 Position Title: Director, Member Experience The Director of Member Experience, reporting to the VP of Client Solutions, is responsible for leading and optimizing member-facing operations across both medical (TPA) and pharmacy (RX) service channels. This role oversees call center operations while driving a broader, organization-wide focus on member satisfaction, accessibility, and engagement. The Director will establish scalable processes, leverage data and insights, and partner cross-functionally to improve service delivery, reduce friction in the member journey, and enhance overall experience and outcomes. Key Responsibilities • Lead member service operations across TPA and RX, ensuring consistent, high-quality member interactions., • Evaluate and improve processes, workflows, and systems to establish scalable and efficient operating models., • Define and monitor performance standards (e.g., service levels, quality, responsiveness, first call resolution)., • Analyze call center metrics and member feedback to identify trends, root causes, and opportunities for improvement., • Develop and implement workforce planning strategies, including capacity modeling, forecasting, and staffing optimization., • Build and maintain performance dashboards to support data-driven decision-making., • Partner with Member Experience Managers to assess performance trends and guide coaching, training, and development efforts., • Implement quality assurance and continuous improvement programs to enhance service outcomes., • Collaborate cross-functionally to address upstream drivers of member inquiries and improve the overall member journey., • Lead initiatives to simplify processes, reduce call volume, and improve member satisfaction across all touchpoints., • Influence stakeholders across operations, pharmacy, and benefits to drive alignment and improvements., • Build, develop, and mentor high-performing teams, fostering a culture of accountability, empathy, and operational discipline., • Perform other duties as assigned. Qualifications Required • Bachelor’s degree required, • Experience in call center or member services operations, preferably in healthcare, • Experience leading teams and developing people leaders, • Experience using data and performance metrics to drive operational decisions and improvements, • Experience with workforce planning, capacity modeling, operational optimization, • Knowledge of call center KPIs and impact on service levels and staffing, • Experience improving processes or workflows in a growing or evolving environment, • Ability to work cross-functionally and influence outcomes Preferred • Experience in both TPA and PBM member support environments, or demonstrated ability to quickly build cross-functional expertise, • Strong proficiency in data analysis tools (Excel advanced functions, Power BI, Tableau, or similar), • Experience implementing new systems, tools, or operational frameworks, • Experience with call center technologies (IVR systems, CRM platforms), • Experience reducing call volume through upstream operation or design improvements, • Exposure to multi-channel support models (phone, chat, digital), • Background in member journey mapping or experience design Key Competencies • Contact center operations leadership, • Data-driven decision making, • Workforce planning and capacity management, • Operational discipline and process optimization, • Analytical and problem-solving skills, • Cross-functional collaboration, • Strategic and systems thinking, • Change leadership and team development