Senior Director, Healthcare Member Contact Center

🕒 6 days ago

🥔 Idaho – Remote

🥔 Idaho – Remote

💵 $152.1k - $190k / year

⏰ Full Time

🟠 Senior

📞 Call Center Representative

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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

📋 Description

• Lead operational redesign and define business strategies that improve service performance, scalability, and operational efficiency across Customer Care. • Establish and oversee integrated staffing models, cross-training strategies, and operational workflows across Customer Care, including PA Intake, specialized teams, and customer communications. • Partner with IT leadership to ensure Customer Care systems and applications effectively support operations, analytics, and reporting, with ongoing evaluation to optimize performance and scalability. • Serve as the accountable business owner for company customer and member experience initiatives, providing end-to-end leadership from strategy development and innovation through execution, adoption, and sustained results. • Define performance standards, service metrics, and operating benchmarks to drive accountability and consistently exceed service-level expectations. • Establish strong cross-functional working relationships between Customer Success, Clinical Services, Technical Operations, and Government Programs, Sales and Implementation departments to ensure seamless service delivery and client onboarding. • Provide strategic oversight of Customer Care workforce planning, forecasting, and capacity modeling by analyzing demand trends, developing forecasts, researching business requirements, workflow design, and business growth requirements. • Lead forward-looking strategy and the adoption of innovative methodologies to continuously enhance call center capabilities, operational performance, and technology advancement. • Drive a culture of continuous operational improvements focused on enhancing customer experience, operational effectiveness, and quality outcomes. • Set strategic direction for associate training, leadership development, and call center certification to ensure workforce readiness and performance excellence. • Evaluate emerging technologies, systems, and sourcing strategies to strengthen Customer Care capabilities and improve serve delivery. • Oversee the development, implementation, and governance of Customer care policies, procedures, and quality frameworks, including performance monitoring and corrective action. • Ensure robust tracking, trending, and reporting of operational metrics, performance guarantees, and service outcomes. • Provide oversight of accreditation, including application preparation, compliance maintenance of necessary documentation to demonstrate compliance with accreditation standards and coordination of on-site reviews.

🎯 Requirements

• Bachelor’s degree in Business or related field, or equivalent work experience required. • 10+ years of progressive leadership experience overseeing large-scale, multi-channel call center or customer care operations, including accountability for performance, staffing, and service outcomes required. • 10+ years of progressive management experience within a managed care, PBM, or comparable highly regulated health care environment, with demonstrated responsibility for complex operations and cross-functional coordination required. • Proven record of operational leadership resulting in measurable improvements in efficiency, productivity, capacity utilization, and service performance through process redesign, workforce optimization, and performance management required. • Demonstrated experience implementing operational and technology improvements within call center environments, including adoption of new methodologies that enhanced efficiency, customer experience metrics, and overall performance required.

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development • STAR Bonus