Director, Customer Care Operations

About the company

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director, Customer Care Operations based in the United States.

Responsibilities

• Lead customer care operations: Oversee day-to-day operations through two Customer Care Managers and 12 Supervisors, with leadership accountability for approximately 150–200 pharmacy technicians and customer service agents supporting members, pharmacies, and clients.
• Drive operational performance: Establish service level, quality, efficiency, and member experience targets, monitor performance against goals, and hold leaders accountable for measurable operational results.
• Use data to improve outcomes: Analyze call trends, escalations, quality results, and operational metrics to identify root causes, prioritize improvement opportunities, and implement sustainable solutions.
• Manage workforce planning and operational budgets: Partner with Workforce Management and Operations leadership to forecast demand, optimize staffing and scheduling, plan capacity, and manage labor costs against budget and forecast.
• Deliver executive-level reporting: Prepare and present operational dashboards, performance insights, and business cases that support decisions about staffing, investment, resource allocation, and operating models.
• Optimize workflows and processes: Lead initiatives to reduce operational friction, eliminate unnecessary rework, improve first-contact resolution, and increase productivity across customer care functions.
• Maintain operational documentation: Oversee process documentation, job aids, workflow guidance, and knowledge management resources to ensure frontline teams have accurate, accessible, and consistent information.
• Lead escalations and issue resolution: Coordinate the investigation of complex service issues, identify underlying causes, align stakeholders, and ensure corrective actions address problems sustainably.
• Leverage technology and automation: Identify opportunities to improve service delivery through Salesforce CRM, Salesforce Knowledge, phone systems, the Member Portal, and other relevant technologies.
• Partner on policy and regulatory compliance: Collaborate with Policy, Compliance, and Legal teams to translate regulatory and legislative requirements into practical procedures, ensuring customer care operations remain aligned with applicable obligations.
• Strengthen quality assurance: Work with Quality Assurance and Compliance leaders to align quality standards and call evaluation criteria with operational priorities, using results to improve coaching, scorecards, and team performance.
• Support training and development: Partner with Training leaders to identify knowledge and skill gaps, shape training initiatives, and reinforce the adoption of new systems, processes, and service expectations.
• Maintain audit readiness: Ensure operational processes and documentation are prepared for audits and regulatory reviews, coordinating with Compliance and Legal to resolve corrective actions within established timelines.
• Develop managers and supervisors: Coach and mentor operational leaders, strengthen leadership capabilities, build succession depth, and foster a culture of accountability, engagement, and continuous improvement.
• Enhance performance management: Maintain and refine agent scorecards, quality measures, and performance management practices that support consistent coaching and fair, data-driven evaluations.
• Champion the frontline and member experience: Engage with frontline employees, review member feedback, and help teams understand changing service expectations, recurring issues, and process improvements.
• Lead strategic operational initiatives: Sponsor major projects, including new client and program launches, transitions, and operating-model changes, ensuring customer care readiness, scalability, and a positive frontline experience.
• Represent Customer Care across the organization: Partner with executive leadership, clients, and cross-functional teams to align operational priorities with broader business goals and contribute to strategic initiatives.

Requirements

• Education: Bachelor's degree in business, healthcare administration, or a related field, or an equivalent combination of education and professional experience.
• Extensive customer care leadership: At least 10 years of experience in call center or customer care operations, including seven or more years in leadership roles managing managers, multiple teams, or large operational organizations.
• Proven operational results: Demonstrated success improving service levels, quality, productivity, operational efficiency, and customer or member satisfaction through data-driven decisi