Customer Solution Center Program Director III
Job Category: Customer Service
Department: Office of CSC Excellence
Los Angeles, CA, US, 90017
Position Type: Full Time
Requisition ID: 8109
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.
This position is responsible for leading the strategic and operational processes and people to support the technological advancement of the Customer Solution Center (CSC).
Responsibilities include overseeing the implementation of projects and enterprise VOICE program, including the design of workflows for process efficiency, leveraging operational system experience to equip the Customer Solution Center with addressing member and provider needs, providing efficient communications between departments and ensuring systems are in place for seamless operations. Advises CSC management on program and process efficiency opportunities.
Ensures future state technology and technological enhancements (through work as CSC's Cross Business Transformation Liaison) are operating in accordance with the organization's mission, values and strategic goals and is responsive as well as sensitive to the needs of L.A. Care's culturally diverse member and provider groups. Works closely with CSC management to ensure the design of solid core operations, leading towards transforming processes and CSC innovation.
Develop and champion technology initiatives and operational programs and associated processes, thereby yielding the development of a high performing customer centeric workforce that enhances LA Care Customer Solution Center services capabilities.
Establish a capability for analyzing process improvements/change needed and determine highest priority areas for support. Develop, prioritize and implement improvements needed to reduce and/or mitigate customer service risk. Establish and manage metrics related to risks that facilitate continuous improvement as it relates to Customer Solution Center. Participate on behalf of CSC in cross functional teams to assess risks to quality and develop action plans to meet CSC goals by enhancing workflow process, service quality and member satisfaction plans consistent with L.A. Care's strategic vision to provide member centric care.
Function as a leader within Customer Solution Center to prioritize cross departmental requests (across all verticals) to ensure alignment to system and department needs. Advise CSC management on areas of key focus of technological focus.
Drive Change management across teams and CSC workforce to ensure effective release of process and system enhancement, in executing continuous process improvements.
Develop, recommend, and lead implementation of cross functional policies and procedures, applying knowledge of operational goals, initiatives, regulatory compliance and capacity to drive better member outcomes.
Develop relationships with key internal and external stakeholders. Work with external peer and industry groups to stay abreast of best practices for all elements of the Customer Solution Center. Act as an senior level spokesperson to update on initiative status to stakeholders and vendors.
Perform other duties as assigned.
In lieu of degree, equivalent education and/or experience may be considered.
Master's Degree in Business Administration or Related Field
At least 6-8 years relevant experience in a call center operations in a managed care health plan setting to include program development and project experience with at least 3 years of experience in implementing process and system improvements.
Experience in business process improvement and the tools and data requirements for supporting an effective business process improvement practice.
Understanding of the operations of LA Care preferred.
Ability to determine the key business issues and develop appropriate action plans from multidisciplinary perspectives.
Excellent skills in complex analytic problem solving, project management, change management, and group process.
Must exhibit efficiency, collaboration, candor, openness, and results orientation.
Proficient in team building, conflict resolution, group interaction, project management, and cost effective and budget management.
Demonstrated ability to conduct and interpret quantitative/qualitative analysis.
Ability to effectively manage in ambiguous situations with minimal direction.
Ability to craft call center scrips, resolve most complex customer service issues using creative problem solving.
Excellent active listening skills to hear customer concerns, apply creative problem solving and de-escalation technics for best outcomes.
Must demonstrate an understanding of regulatory requirements for call center inquiries and ability to implement measures to ensure compliance related to the responsible area.
Knowledgeable in QNXT, TRiZetto systems, Universal Desk in/outbound.
Knowledgeable in the 824 and 834 enrollment process.
L.A. Care offers a wide range of benefits including
+ Paid Time Off (PTO)
+ Tuition Reimbursement
+ Retirement Plans
+ Medical, Dental and Vision
+ Wellness Program
+ Volunteer Time Off (VTO)
At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.