Director, Operations (Government Markets)

Blue Shield of California • Lodi, CA

2d • Hybrid

About The Position

The Government Markets Customer Experience team supports member interactions from our Government Markets members. The Director, Government Markets Customer Service will report to the Sr. Director, Government Markets Customer Experience. Through strategic leadership and oversight of frontline agents, supervisors, and managers, the Director of Government Markets Customer Experience ensures every member interaction reflects Blue Shield's commitment to delivering service worthy of our family and friends. By fostering a culture of accountability, compassion, and continuous improvement, this leader drives exceptional service experiences that strengthen member trust, improve outcomes, and advance Blue Shield's mission. Their leadership enables teams to consistently deliver personalized, high-quality support that makes healthcare easier to navigate and more accessible for the members we serve. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Requirements

• Requires a bachelor's degree or equivalent experience
• Requires at least 10 years of prior relevant experience, including at least 6 years of management experience
• Requires robust knowledge of health insurance, preferably in the Government Markets lines of business
• Requires extensive leadership experience and proven track record of driving sustained performance in call center operations

Responsibilities

• Provide strategic and operational leadership for inbound contact center operations supporting Government Markets lines of business, including Individual & Family Plans (IFP), Medi-Cal, Medicare, and Medicare Supplement
• Lead and develop a high-performing organization of frontline agents, supervisors, and managers to deliver exceptional member experiences aligned with Blue Shield's mission and service standards
• Drive performance against key operational metrics, including service level, quality, issue resolution, member satisfaction, Net Promoter Score (NPS), compliance, and cost efficiency
• Ensure consistent delivery of accurate, compassionate, and timely service for members navigating healthcare benefits, coverage, claims, provider access, and care-related inquiries
• Partner cross-functionally with Operations, Clinical, Product, Provider Services, Appeals & Grievances, Compliance, and Technology teams to resolve member issues and improve end-to-end experiences
• Lead customer experience Improvement initiatives in partnership with cross functional teams, leveraging technology, process optimization, automation, and self-service capabilities to improve member outcomes and operational efficiency
• Ensure adherence to regulatory requirements and contractual obligations associated with Medicare, Medi-Cal, and other Government Markets programs
• Utilize data, analytics, and member feedback to identify trends, address root causes, and implement sustainable improvements that enhance both member and employee experiences
• Serve as a trusted leader and advocate for members, championing Blue Shield's commitment to provide service worthy of our family and friends through every interaction and touchpoint

What This Job Offers

• Job Type: Full-time
• Career Level: Director