Head of Customer Service Operations

The southern California Local Member Service Department is a regionally based team with offices located throughout Southern California Medical Centers.

While the work location for this position will be located around the LA basin, this Director role will primarily be responsible for overseeing Member Services Operations at Woodland Hills Medicalcenter and West LA Medical Center. This role will be expected and must be able to travel to additional sites/locations as needed to support operations/business objectives.
Provide leadership, overall management, strategic direction, and support to the Local Member Services professional staff, across multiple sites. Responsible for Member Services daily operations, initiatives, oversight of case processing, issue resolution, quality of information and service provided by staff to both internal and external customers. Support and represent Kaiser Foundation Health Plan Member Services, and strategize with Regional and Local leadership, facility personnel, and physicians to minimize the financial risk to the organization and ensure contract integrity for our members as well as Kaiser Permanente. Provide performance based consulting to department management and facilities throughout Northern California. Provide service recovery in order to assist in the retention of our members. Drive the mission and business results for Kaiser Permanente while meeting budgetary guidelines to ensure responsible stewardship of our members dues.
Provides leadership (responsibility and oversight/management) for member services at the medical center and medical offices for designated facilities, including budgetary, compliance, service and quality oversight.
Identifies member and non-member pain points, and works with area leaders to drive continuous service improvements, partnering with these local and regional leaders to reduce complaints and grievances, while increasing member satisfaction, growth and retention.
Acts as key liaison with the medical group; develops programs and service improvements in conjunction with key medical group personnel, managers, and physicians, to improve member experience and resolve member issues as quickly and effectively as possible.
Handles high risk issues by managing timely communication with medical facilities.
Provides ongoing information, reports and recommendations to facility departments and physician chiefs related to data analysis and provision of reports and information related to services and concerns that arise in specific departments.
Oversees the daily operations of the member services department, including linkage with auditing, training and analyst work to best meet the needs of staff, members, key stakeholders, and leadership.
Identifies member-system conflict in an effort to prevent professional liability, minimize financial penalties to the organization, and retain satisfied members.
Hires, supervises, coaches/trains and develops staff who handle sensitive and multi-faceted member issues and requests.
Creates a team atmosphere and structure that promotes self-directed work through the development and empowerment of staff.
Orients and educates facility departments, physicians and other professional staff regarding health plan products, benefits, regulatory guidelines, resolution of member questions, complaints and grievances.
Fosters a service oriented work environment with an emphasis on dedication to serving members, affording respect to individuals, achievement of highest standards of quality, identifying and supporting opportunities for innovation, supporting teamwork and implementing policies and practices that reflect the vision of KP.
Minimum eight (8) years of management/leadership experience in a complex healthcare (preferably HMO) or service-oriented organization
Minimum three (3) years of experience in customer service improvement and process redesign, with openness to creative and innovative approaches to providing service, including cultural sensitivity, respect and polite communication with patients and all clientele
Minimum three (3) years of experience working with accreditation and regulatory agencies and/or preparing information for regulatory audits as requested, (including, but not limited to Department of Health Services (DHS), Department of Managed Healthcare (DMHC), National Committee for Quality Assurance (NCQA), and Center for Medicare/Medicaid Services (CMS)
Bachelors degree in Health Care Administration, Business Management, Science or Business or four (4) years of experience in a directly related field.
High School Diploma or General Education Development (GED) required.
License, Certification, Registration

~ Outstanding interpersonal/communication and mediation skills with ability to effectively partner with a wide group of stakeholders, including professional and medical staff
Demonstrated management and leadership skills, including working with varied levels of staff, budgeting, delegation, staff development, coaching, resource allocation planning, and performance management
Demonstrated ability in development of team focus, partnership, service orientation, influence and change leadership
Demonstrated awareness in emotional intelligence as modeled in day-to day leadership responsibilities
Demonstrated ability to lead, collaborate, communicate, influence and partner effectively with senior leadership and a broad base of business and functional leadership.
Proven ability and commitment to work collaboratively in a Labor Management Partnership
Word (compose executive summaries/reports), Excel (open spreadsheets, create graphs), Power Point (create executive presentations), Electronic Medical Record, Statistical Analysis Programs
Oversee two hospitals and provide on-site leadership across multiple service areas throughout the LA Basin as needed.

California,Woodland Hills,Woodland Hills Medical Center
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Job Schedule: Full-time
Employee Group/Union Affiliation: NUE-SCAL-01|NUE|Non Union Employee
Pay Range: $117100 - $151470 / year Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: Yes, 50 % of the Time
On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.
Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.
Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; conducts business with honesty, shows consistency in words and actions; 2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (