Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

Reporting to the Senior Vice President, Service and Experience, the Director, Member Service Excellence, leads and manages a large team (500 +) of service professionals that provide outstanding service to Point32Health members. Our service approach is centered on leading with empathy, meeting our members where they are, and an unrelenting focus on quality, issue resolution and advocacy. The director is responsible for ensuring a culture of innovation and continuous quality improvement; a fully engaged and high performing staff; effective and efficient practices and processes and ongoing measures to achieve the best-in-class service experience for our members. Service is one of Point32Health’s key marketplace differentiators: Members choose to join and stay with Point32Heath because of our service excellence. This role is highly visible and requires strong partnership and integration with leadership across the enterprise. This role has budget responsibilities of 45M.

Job Description

Key Responsibilities/Duties – what you will be doing (top five)

• Service Center Operations- Lead the day-to-day member service operations comprised of a 500+ seat service center and outsourced service vendors. Establishes and monitors KPIs (hourly, daily, monthly) to ensure both efficiency and quality are achieved including both state and federal regulatory requirements and commercial account performance guarantees.
• Cultivate a High Performing Culture- Demonstrate strong leadership, support active colleague engagement and an open supportive culture; drives data driven performance management and a member centric mindset. Communicates clear expectations to ensure colleagues understand how their roles contribute to Point32Health’s success; hires and onboard the right talent; develops strong leadership and coaching culture, sets clear KPIs and shares performance openly to foster accountability and transparency; celebrates wins and learns from challenges.
• Strategic Leadership- Deliver a short term and long-term Service Center vision and operating plan annually. This includes ensuring that market segment service needs are met and the development of customized and scalable service model as needed.
• Next Gen Service Operations- Partnering closely with our Information Technology team, the Director, Member Service Excellence will leverage advanced technologies and AI driven insights to improve efficiency, reduce costs, and enhance the member experience. Our service models must shift from traditional models to intelligent, predictive, proactive service operations and omnichannel capabilities.
• Innovation and Process Improvement Mindset-To support our goal of delivering high quality and efficient service, the Member Service Excellence Director will focus on proactively finding better ways to do things and refining existing processes. Leveraging Design Thinking principles and engaging service center colleagues at all levels, the director will identify and implement at a minimum two initiatives annually
• Other duties and projects as assigned

Qualifications – what you need to perform the job

Certification and Licensure

Education

• Required (minimum): Minimum of 10 – 15 years in leading customer service operations
• Preferred: Health Care/Health insurance experience preferred

Experience

• Required (minimum): Minimum of 10 – 15 years in leading customer service operations
• Preferred: Health Care/Health insurance experience preferred.

Skill Requirements

• Mastery of Service Center operational metrics and work force management discipline including flex staffing and AI enabled staffing algorithms.
• Expert knowledge of next gen service platforms and systems including AI enabled Contact Center as a Service, Customer Relationship Management systems, self-service modalities and omnichannel environments.
• Action orientation and ability to drive organizational change.
• Ability to think conceptually and effectively translate concepts into practical and executable plans.
• Strong analytical skills, with the ability to articulate and define outcome measures that capture key performance metrics.
• Excellent collaboration and relationship management skills.

• Strong communication skill sets, with the ability to present information in a variety of different formats to all levels of stakeholders.

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

Disclaimer

• The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage

• Retirement plans

• Paid time off

• Employer-paid life and disability insurance with additional buy-up coverage options

• Tuition program

• Well-being benefits

• Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

We welcome all
All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org

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