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Director, Customer Service Government Healthcare Programs

Posted on Feb 14, 2020 by Highmark Inc

Pittsburgh, PA 15201
Health Care
Immediate Start
Annual Salary
Company : Highmark Inc Job Description :


This job will lead HPO's call center operations focused on servicing members within our Government healthcare programs. The incumbent is responsible for oversight, leadership and strategy across multiple locations, focused on achievement of all established KPI's and industry specific designations such as STARS, PALS & CAHPS. Strategic planning, developing and directing of the call center operations and customer service programs, ensuring compliance with all rules, regulations, policies, and procedures as set forth by CMS and other regulatory agencies. Understands impact of new regulations and evaluate changes required to processes and procedures of the service operational areas in order to ensure compliance.


  • Establish and communicate the service standards to the operations to achieve the highest quality and customer satisfaction. Develop and implement controls to ensure that the appropriate performance and trend reporting is in place. Lead the development and updating of customer service policies and procedures that representatives can follow to ensure customers receive effective, fast, and reliable responses to concerns.
  • Lead the development and updating of customer service policies and procedures that representatives can follow to ensure customers receive effective, fast and reliable responses to concerns. In partnership with Learning & Development, supports the development and implementation of training to ensure employees are educated on client specific requirements.
  • Evaluate changing business strategies in collaboration with key stakeholders, to ensure the impact to the various business unites is properly assessed to ensure successful achievement of all goals.
  • Provide consistent reporting to key stakeholders including Government Quality and MA Retention, as necessary regarding service performance, issues and challenges.
  • Oversee and ensure execution of outbound call campaigns focused on enhancing member satisfaction and retention through Welcome Calls, Formulary Outreach and other health enhancing efforts.
  • Other duties as assigned or requested.


  • Bachelor's Degree
    • Substitutions: 10 years of related customer service management experience
  • 7 years of Health Plan member experience leadership, specifically Medicare/Medicaid
  • 5 years of Management experience
    • To Include:
      • Call center experience
      • Experience interfacing with multiple clients
      • Experience defining and implementation exceptional call center operations
      • Experience identifying and implementing automated solutions
      • Experience leading and motivating large (300+ employees) operations/customer call center teams


  • 7 years of Experience managing global call centers


  • Analytical skills including critical and strategic thinking
  • Clear and concise verbal and written communication skills
  • Ability to work independently and in a matrixed team environment

Travel Required: 0% - 25%

Referral Bonus: Level 3


Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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