Associate Director, Contact Center Operations

Brighton Marine, Inc•Boston, MA

8d•Hybrid

About The Position

The Associate Director, Contact Center Operations is responsible for delivering operational excellence, regulatory compliance, and exceptional member and provider experiences across Brighton Marine, Inc. This role provides both strategic and hands-on leadership for the health plan contact center and is instrumental in scaling operations to support new business lines and organizational growth. The Associate Director will design, build, and continuously optimize the contact center infrastructure—including people, processes, technology, and performance management frameworks—to ensure service levels, quality standards, compliance requirements, and budgetary targets are consistently met. This leader will hire, train and manage a team of 12 or more call center representatives to be hired later this year, driving high performance through coaching, accountability, and data-driven decision-making while ensuring a superior member and provider experience. Serving as a strategic advisor to senior leadership, this role will guide the organization in scaling a fiscally responsible, compliant, and highly effective contact center operation that supports the organization’s long-term goals.

Requirements

Bachelor's degree in healthcare administration, business administration, or related field, or 8+ years of healthcare operations experience.
6 + years of leadership experience managing payer health plan contact center operations, including member services, provider services, claims, prior authorizations, and/or appeals.
Demonstrated expertise in health plan operations, including benefits administration, prior authorizations, claims processing, and appeals workflows.
Experience developing and maintaining operational SOPs and business requirement documents.
Excellent written and verbal communication skills, with the ability to influence stakeholders across all organizational levels.
Ability to lead, coach, and develop frontline teams while managing competing priorities in a fast-paced environment.
Background in developing training curricula, onboarding programs, and ongoing performance development initiatives.
Strong analytical and problem-solving skills with the ability to translate data into operational improvements.
Familiarity with implementing or utilizing workforce management concepts, including forecasting, scheduling, and capacity planning.
Strong working knowledge of contact center operations, including IVR design, call routing, queue management, and service level optimization.
Proficiency using CRM platforms, contact center technologies, and performance reporting tools.
Experience designing and leveraging operational dashboards and KPIs to drive performance and accountability.
Must be able to obtain and maintain U.S. Government personnel security clearance as a condition of employment.
Candidates must be authorized to work in the United States without sponsorship now or in the future.

Nice To Haves

Experience building or scaling startup or growth stage health plan contact center teams, processes, and infrastructure preferred.
Knowledge of Department of Health Administration (DHA) requirements and applicable state and federal healthcare regulations preferred.

Responsibilities

Lead and oversee the day-to-day operations of the contact center supporting health plan members and providers.
Establish, monitor, and optimize key performance indicators (KPIs), including service level agreements (SLAs), average speed of answer, first-call resolution, quality scores, productivity, and member/provider satisfaction.
Use data and reporting to identify trends, mitigate risks, and drive continuous operational improvement.
Ensure operational readiness and scalability to support new products, programs, and organizational growth.
Own and optimize contact center technologies, including CRM systems, telephony platforms, workforce management tools, quality monitoring solutions, and reporting dashboards.
Partner with IT and business stakeholders to identify, implement, and enhance technology solutions that improve efficiency, quality, and the member/provider experience.
Maintain systems and workflows to support regulatory requirements and accurate documentation.
Ensure compliance with Department of Health Administration requirements and all applicable state and federal regulations.
Develop, maintain, and enforce standard operating procedures (SOPs) to ensure consistent, compliant, and high-quality service delivery.
Build, implement, and evolve a comprehensive quality assurance (QA) program, including auditing, calibration, feedback loops, and corrective action planning.
Lead internal readiness for audits, reviews, and regulatory inquiries related to contact center operations.
Lead, coach, and develop contact center leadership (e.g., managers, supervisors) and frontline staff to drive engagement, accountability, and high performance.
Define workforce models, staffing plans, and capacity strategies to align with business needs.
Design and oversee onboarding and training programs that ensure staff competency, regulatory knowledge, and customer service excellence.
Foster a culture of continuous learning, collaboration, and employee engagement.
Develop and manage the contact center operating budget, ensuring fiscally responsible decision-making.
Identify cost-efficiency opportunities while maintaining service quality and compliance.
Collaborate with cross-functional leaders to align contact center strategy with organizational objectives.
Serve as a thought partner to senior leadership on scaling operations, driving innovation, and improving the overall member and provider experience.