Director, Staffing Transformation & Operations

Key Responsibilities

Staffing Strategy & Workforce Management

• Own the multi-year Member Care staffing strategy across channels, roles and staffing type, ensuring alignment with company growth plans, product roadmap, and client commitments.

• Translate demand forecasts into clear capacity, staffing, skilling, and scheduling requirements across internal and outsourced teams.

• Lead the workforce management function, including long-term capacity planning, short-term staffing plans, schedule design, skilling, real-time management, and feedback loops between plan and actual performance.

• Evolve the staffing model through segment-based role design, cross-skilling, and routing strategy to improve service delivery, efficiency, and employee experience.

• Define the next phase of the staffing model in an AI-forward environment , including how work should shift away from purely inbound, next-available handling.

Vendor Management

• Own Member Care’s current and long term vendor strategy- who we partner with, how and for what defined value.

• Proactively identify and mitigate vendor and operational risk through contingency planning, diversification, and surge or outage coverage strategies.

• Define and maintain performance standards and KPIs for vendor partners (e.g., service levels, quality, MSAT, AHT , escalation rates, adherence, error rates, unit cost).

• Oversee the management of BPO relationships.

• Ensure BPO partners are trained, enabled, and informed at the same standard as internal teams by coordinating with Training, Knowledge, Quality Coaching, and Product/IT.

• Partner with Legal, Procurement, IT, Cyber Security and Finance on contracting, pricing, tech enablement, security and commercial terms, ensuring we can meet both performance and margin goals.

• Build and maintain a robust issue and escalation management process with vendors, ensuring clear ownership, timely root cause analyses, and durable corrective actions.

• Ensure systems are set up for accurate invoice reconciliation with our vendors.

AI Enablement, Productivity, & Tooling

• Own and centralize the Member Care AI enablement roadmap into one prioritized view of opportunities, bets, and expected impact.

• Partner across Product, Engineering, IT, and Operations to identify, prioritize, and scale AI and automation opportunities that improve frontline workflows and member experience.

• Modernize how productivity is defined and measured so it better reflects complex, non-queue-based work and AI-augmented service delivery .

• Use data and structured experimentation to refine staffing models, routing strategies, partner allocations, and AI priorities .

Operational Performance, Analytics, & Tooling

• Own a core set of staffing, productivity, vendor, and financial performance metrics, including service level, staffing efficiency, occupancy, utilization, adherence, quality, unit cost, and BPO versus internal mix .

• Partner with Analytics and Finance to connect demand, capacity, staffing decisions, service outcomes, and financial results in a way that supports better in-year decision-making.

• Collaborate with Product, Engineering, and IT on tooling requirements related to IVR , chat routing, WFM platforms , skills management, and reporting, ensuring systems support the complexity of the staffing model.

• Drive a disciplined test-and-learn approach to staffing (e.g., pilots on tiering, routing strategies, channel mix, BPO vs. internal allocations ) and ensure learnings are documented and institutionalized.

Leadership, People Development, & Culture

• Lead, coach, and develop a high-performing team that includes ICs and people-managers.

• Set a clear vision, strategy, and roadmap for the staffing and vendor management function, with defined milestones and success metrics over an 18-month horizon .

• Foster a culture of partnership, transparency, and shared accountability across all cross-functional partners.

• Represent the company’s staffing and vendor strategy in executive leadership forums and, as needed, in client, prospect, and RFP settings .

Cross-Functional Collaboration

• Partner closely with Staffing Forecasting to align on forecasting assumptions, surge plans, and tooling needed to execute the staffing strategy.

• Collaborate with Member Care Advocacy and Service Excellence to ensure staffing and vendor decisions reflect member experience goals, escalation themes, and quality insights.

• Work with Operations Enablement and Project Management on the staffing implications of new clients, new products, and major operational changes (e.g., routing redesigns, new service lines).

• Coordinate with Finance on budget planning, margin improvement initiatives, and unit cost tracking tied to staffing and vendor performance.

• Partner with Client Success and Sales to help explain our staffing and vendor strategy to clients and prospects, as needed, including in RFP responses , client design sessions, and client business reviews.

Qualifications

Experience:

• 10+ years of experience in staffing strategy, operating model design and/or transformation or a related operational strategy function, including at least 2 years in a people management role.

• Consulting background, particularly in strategy, operations, or transformation work, is strongly preferred.

• Proven experience leading cross-functional operating model or service transformation initiatives in a high-volume, multi-channel environment.

• Experience partnering with senior leaders across operations, finance, product, technology, and external partners to drive complex operational change.

• Experience leading technology-enabled transformation, including AI , automation, workflow redesign, or tooling modernization.

• Experience in healthcare, health benefits, or another highly regulated service environment strongly preferred.

Skills:

• Exceptional strategic and systems thinking, with the ability to connect forecasts, staffing levers, service design, technology investments, and business outcomes.

• Strong analytical and commercial judgment, with comfort working with complex operational and financial datasets and making tradeoff decisions tied to service, savings, and execution risk.

• Ability to lead enterprise change through influence and align cross-functional stakeholders in environments where authority is shared.

• Strong judgment in identifying, prioritizing, and scaling AI , automation, and workflow redesign opportunities based on operational and business impact.

• Clear and confident communication, including experience presenting to senior leaders, executive forums, and external partners.

Education:

• A Bachelor’s degree is required. A degree in Business, Operations Research, Statistics, Industrial Engineering, Healthcare Administration, or a similar field is preferred.

• Advanced degree (e.g., MBA , MHA , MS in Operations Research or Analytics ) is a plus.

Additional Requirements:

• Ability to work in a fast-paced, dynamic environment with competing priorities and tight timelines.

• Interest for Included Health’s mission to raise the standard of healthcare for everyone.

• Willingness to travel up to 10-20% as needed for key internal meetings, site visits, and vendor/client engagements.

Physical / Cognitive Requirements:

Physical Requirements:

• Stamina, strength, mobility, manual dexterity, vision, hearing, environmental factors.

• Ability to effectively communicate and engage with others, with accommodations available for visual or auditory impairments.

• Ability to handle physical tasks related to the job, with accommodations provided as needed.

• Ability to respond effectively to changing situations, with accommodations available for varying response times.

• Prompt and regular attendance at assigned work location.

• Ability to remain seated in a stationary position for prolonged periods.

• Requires eye-hand coordination and manual dexterity sufficient to operate keyboard, computer and other office-related equipment.

• No heavy lifting is expected, though occasional exertion of about 20 lbs. of force (e.g., lifting a computer / laptop) may be required.

Cognitive Requirements:

• Problem-solving, decision-making, attention to detail, critical thinking, communication skills, stress tolerance.

• Facilitate communication and collaboration with clients and stakeholders.

• Adaptability to different work environments, with support provided for managing workload and pace.

• Ability to maintain focus and attention on tasks, with accommodations available for individuals with attention-related conditions.

• Ability to interact with leadership, employees, and members in an appropriate manner.