Sr. Director, Customer Service and Interaction Management, Commercial
Apply NowCompany: Blue Shield Of California
Location: Rancho Cordova, CA 95670
Description:
Job Description
There's never been a better time to join Blue Shield!
Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California is focused on transforming health care by making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 6 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Your Role
The leader Customer Service and Interaction Management, Commercial for Blue Shield of California is an ambassador for our mission to 'Create a health care system that is worthy of our family and friends and is sustainably affordable.' This individual is an important member of the company's Customer Experience team and is responsible for developing end-to-end customer service strategies for all lines of business. The Sr. Director, Customer Service and Interaction Management is also responsible for informing upstream processes and improvement opportunities.
The Customer Service and Interaction Management, Commercial reports to the VP, Customer Experience and is a people leader with responsibility for approximately 700 FTEs, including Directors, Managers, Supervisors, Business Analysts, Customer Service Representatives and support staff located in multiple sites. The total financial responsibility for the department is approximately $155 million annual cost budget.
Responsibilities
Your Work
In this role, you will:
The position is ideally located in El Dorado Hills or Lodi, California. However, there is some flexibility for our California office locations if needed.
Specifically, the Customer Service and Interaction Management, Commercial role will be accountable to:
Collaborate in the development and implementation of immediate and long-term, division-wide business operating strategies and plans
Create an end to end process for managing customer contacts to deliver a superior experience for Blue Shield customers
Develop and manage customer feedback system to drive upstream process improvements to improve customer experience and lower operating costs
Apply proven quality improvement methods as well as necessary coaching, learning, and training to achieve performance goals to continuously improve the Member Service group's performance
Guide, develop and execute long range strategic plans (3-5 years), including technology roadmap
Manage annual operating plans and budgets for Blue Shield's customer service operations
Define and implement organizational structures to effectively manage Member Service functions for all lines of business and products
Define, track, and manage key performance metrics for Customer Service operations and ensures that objectives are consistent with external and internal customer expectations and meet competitive benchmarks
Coordinate with all business stakeholders to ensure linkage with business unit goals and objectives, ensuring sufficient capacity and quality/production support will be available to meet these goals
Regularly identify and evaluate various technology solutions that improve cost, quality and productivity of Customer Service business processes; work collaboratively with IT Division to build and maintain necessary technology platform for effective Member Service delivery
Develop sourcing strategy for all key customer service functions; manage outsourcing relationships necessary to improve overall financial and customer service performance
Membership: Drive and support growth by delivering core line of business commitments around acquisition, engagement, digital support, as well product and customer experience deliverables
Revenue: Achieve or exceed Growth's revenue plan
Operating Income: Achieve or exceed the operating income plan
Achieve the financial plan of while achieving or exceeding service levels
Support the improvement of the Medicare Star rating by leading the Medicare call center to achieve 4.5 rating or higher
Achieve or exceed MTM/LOS targets
Execution: Support transformation initiatives
Qualifications
Your Knowledge and Experience
About the Team
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!
Our Values:
Our Workplace Model:
At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working:
o Member-facing and approved out-of-state roles remain remote.
o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.
o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
There's never been a better time to join Blue Shield!
Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California is focused on transforming health care by making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 6 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Your Role
The leader Customer Service and Interaction Management, Commercial for Blue Shield of California is an ambassador for our mission to 'Create a health care system that is worthy of our family and friends and is sustainably affordable.' This individual is an important member of the company's Customer Experience team and is responsible for developing end-to-end customer service strategies for all lines of business. The Sr. Director, Customer Service and Interaction Management is also responsible for informing upstream processes and improvement opportunities.
The Customer Service and Interaction Management, Commercial reports to the VP, Customer Experience and is a people leader with responsibility for approximately 700 FTEs, including Directors, Managers, Supervisors, Business Analysts, Customer Service Representatives and support staff located in multiple sites. The total financial responsibility for the department is approximately $155 million annual cost budget.
Responsibilities
Your Work
In this role, you will:
The position is ideally located in El Dorado Hills or Lodi, California. However, there is some flexibility for our California office locations if needed.
Specifically, the Customer Service and Interaction Management, Commercial role will be accountable to:
Collaborate in the development and implementation of immediate and long-term, division-wide business operating strategies and plans
Create an end to end process for managing customer contacts to deliver a superior experience for Blue Shield customers
Develop and manage customer feedback system to drive upstream process improvements to improve customer experience and lower operating costs
Apply proven quality improvement methods as well as necessary coaching, learning, and training to achieve performance goals to continuously improve the Member Service group's performance
Guide, develop and execute long range strategic plans (3-5 years), including technology roadmap
Manage annual operating plans and budgets for Blue Shield's customer service operations
Define and implement organizational structures to effectively manage Member Service functions for all lines of business and products
Define, track, and manage key performance metrics for Customer Service operations and ensures that objectives are consistent with external and internal customer expectations and meet competitive benchmarks
Coordinate with all business stakeholders to ensure linkage with business unit goals and objectives, ensuring sufficient capacity and quality/production support will be available to meet these goals
Regularly identify and evaluate various technology solutions that improve cost, quality and productivity of Customer Service business processes; work collaboratively with IT Division to build and maintain necessary technology platform for effective Member Service delivery
Develop sourcing strategy for all key customer service functions; manage outsourcing relationships necessary to improve overall financial and customer service performance
Membership: Drive and support growth by delivering core line of business commitments around acquisition, engagement, digital support, as well product and customer experience deliverables
Revenue: Achieve or exceed Growth's revenue plan
Operating Income: Achieve or exceed the operating income plan
Achieve the financial plan of while achieving or exceeding service levels
Support the improvement of the Medicare Star rating by leading the Medicare call center to achieve 4.5 rating or higher
Achieve or exceed MTM/LOS targets
Execution: Support transformation initiatives
Qualifications
Your Knowledge and Experience
- BS required; MBA a plus
- Minimum 12 years prior relevant experience, including 6 years of management experience
- Experienced in driving enterprise-level change initiatives, including successfully influencing and collaborating with senior executives (including C-level and Board) and challenging the status quo and implementing change that has a positive and lasting impact on the business
- Experience in developing business strategies, including technical implementations, adopting and innovating new technologies and capabilities while achieving expected project returns (NPV/ROI) (including CRM-related technology)
- Demonstrated people leadership skills with ability to engage and motivate people at all levels of the organization
- Experience implementing new organizational structures and technical system designed business processes, while implementing and maintaining critical operating controls/metrics for large multi-functional customer service operations
- Strong financial and analytical skills; able to manage cost statements, readily identify drivers of lower-than-expected performance, and proactively seek performance improvements as necessary to meet necessary cost and customer service performance metrics
- Experience in evaluating, negotiating, and managing financial and operational arrangements with third party vendors
- Experience with process improvement strategies and tactics such as LEAN or Six Sigma is strongly preferred.
About the Team
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!
Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working:
- Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above).Exceptions:
o Member-facing and approved out-of-state roles remain remote.
o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.
o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
- On-Site: Work from a business unit-approved office an average of four (4) or more days a week.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.