At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Job Summary: The Senior Director of Member Services is responsible for leading and managing the Member Services department, which includes the Contact Center, Claims, Escalation, and Clinical Teams. This role ensures the delivery of exceptional service to our members, drives operational efficiency, and fosters a culture of continuous improvement. The Senior Director of Member Services will develop and implement strategies to enhance member satisfaction, streamline processes, and achieve organizational goals. Additionally, this role will involve representing the operations team in client-facing interactions to ensure alignment and satisfaction. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:
- Leadership and Management
- Provide strategic direction and leadership to the Member Services department, including the Contact Center, Claims, Escalation, and Clinical Teams
- Develop and implement policies, procedures, and best practices to ensure high-quality service delivery
- Foster a positive and collaborative work environment that encourages professional growth and development
- Contact Center Operations
- Oversee the management of the Contact Center to ensure efficient handling of member inquiries, complaints, and service requests
- Implement technologies and processes to improve call handling, reduce wait times, and enhance member experience
- Monitor performance metrics and implement corrective actions as needed
- Claims Management
- Ensure the accurate and timely processing of member claims
- Develop and implement strategies to reduce claim processing times and improve accuracy
- Collaborate with other departments to resolve complex claims issues and improve overall claims management processes
- Escalation and NPS Management
- Oversee the escalation process to ensure timely and effective resolution of member issues
- Develop and implement escalation protocols and training programs for staff
- Manage close the loop processes on transactional and annual NPS surveys as well as action planning to improve overall NPS
- Monitor escalation and NPS trends. Implement strategies to reduce the frequency and severity of escalations, as well as feeding back opportunities to operations, product, and technology teams
- Clinical Team Oversight
- Provide leadership and direction to the Clinical Team to ensure the delivery of high-quality clinical services to members
- Collaborate with clinical staff to develop and implement care and case management programs and initiatives
- Ensure compliance with regulatory requirements and industry standards
- Performance Monitoring and Reporting
- Establish and monitor key performance indicators (KPIs) for all departments
- Prepare and present regular reports on department performance to senior leadership
- Partner with the Performance Management team to use data and analytics to drive decision-making and continuous improvement as well as maintain and improve Global Solutions' dedicated systems
- Collaboration and Partnerships
- Collaborate across Global Solutions departments to ensure a seamless and efficient end to end experience for members and clients
- Collaborate and partner with the Market CEO and VP of Network and Partnerships to drive product and growth initiatives
- Develop and maintain solid relationships with key stakeholders to support organizational goals
- Participate in strategic planning and decision-making processes to align member services with broader business objectives
- Enterprise Collaboration
- Collaborate with domestic enterprise teams to ensure systems and processes are "fit for purpose" to accommodate global members
- Engage in broader enterprise initiatives to identify opportunities for the Global Solutions team to advance or take advantage of capabilities developed within the broader Operations & Experience team
- Develop strategies to address the unique needs of international customers in 135 different countries
- Client-Facing Responsibilities
- Represent the operations team in client-facing interactions to ensure alignment and satisfaction
- Communicate operational strategies, updates, and performance metrics to clients
- Gather client feedback and collaborate with internal teams to address concerns and improve service delivery
- Build and maintain solid relationships with clients to support long-term partnerships
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:
- 10+ years of experience in a leadership role within member services, customer service, or healthcare operations
- Experience leading through influence in a large, matrixed, global environment
- Experience in managing international operations and collaborating with global teams
- Solid understanding of contact center operations, claims management, escalation processes, and clinical services
- Knowledge of regulatory requirements and industry standards in healthcare
- Proven record of managing large teams and driving operational excellence
- Proven excellent communication, leadership, and people skills
- Demonstrated ability to analyze data, identify trends, and implement effective solutions
- Willingness to travel up to 25% with some potential international travel
Preferred Qualifications:
- Project Management Certification / PMP or similar certification
- Expertise in leading change management initiatives
- Proven solid financial, strategic, and business acumen, able to interpret key financial and operational metrics and use them to drive change at all levels of the organization
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy The salary range for this role is $150,200 to $288,500 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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