Director, Customer Care Business Integration (Grievances & Appeals Experience Preferred)

Job Summary:

The Director, Customer Care Business Integration will be responsible for leading the strategic alignment and integration of customer care operations across all business functions. This individual will work closely with cross-functional teams to design and implement solutions that enhance customer service delivery, streamline operational processes, and ensure alignment with business, state, regulatory objectives.

Essential Functions:

• Develop and execute a comprehensive customer care integration strategy and execution plans that aligns with company goals, ensuring the seamless integration of customer care operations across all business areas
• Partner with key stakeholders from departments such as IT, Operations, Sales, and Marketing to ensure smooth integration of customer service processes and systems
• Identify opportunities for continuous improvement in customer care processes
• Lead and manage change initiatives within the customer care function, ensuring successful implementation and adoption of new processes, technologies, and systems. Leverage industry best practices to drive operational efficiency and improve the customer experience.
• Oversee complex integration projects, ensuring they are completed on time, within budget, and meet quality standards
• Establish performance metrics and KPIs to monitor the effectiveness of customer care integration efforts, ensuring the utilization of data and analytics to drive decision-making, providing insights and recommendations to optimize customer care performance and measurable improvements in service delivery, customer satisfaction, and operational efficiency
• Manage, mentor, and develop a high-performing team of professionals to drive business integration efforts and ensure effective execution of customer care initiatives
• Act as the primary liaison between senior leadership, customer care teams, and other departments, ensuring clear and transparent communication of integration plans and progress
• Act as primary liaison to support growth activities
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s degree in business administration, Operations Management, a related field, or equivalent years of relevant work experience is required
• Ten (10) years of experience in customer care, business integration, or related fields, with at least five (5) years in a leadership role
• Experience leading complex business integration initiatives and managing cross-functional teams in a health plan environment

Competencies, Knowledge and Skills:

• Strong understanding of customer care requirements, technologies and systems, such as Customer Service, Grievance & Appeals, Digital Service products
• Ability to drive process improvements and deliver measurable results in a customer care environment
• Strong strategic thinking, problem-solving, and decision-making skills
• Excellent project management skills with a proven ability to manage multiple projects simultaneously
• Exceptional communication and interpersonal skills, with the ability to collaborate effectively at all levels of the organization
• Ability to influence and drive change across various business units
• Knowledge of customer care best practices, industry trends, and emerging technologies
• High level of proficiency in data analysis and performance reporting

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Occasional travel may be required

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.