Director, Service & Experience Business Optimization

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

Reporting to the SVP Service and Experience, the Director, Strategy and Business Operations is responsible for strategy, business planning, innovation, budget, project management, business continuity, vendor management systems/technology and AI enablement to support the Service and Experience Department.

This position requires a hands-on, self-motivated, smart, resourceful, and emotionally intelligent individual who thrives in a fast-moving, dynamic environment. This person anticipates the needs and concerns and works to provide logical, innovative, and creative solutions without explicit instruction. Expected to communicate changes in prioritization and decision-making efficiently and be capable of carrying out multiple projects while effectively prioritizing tasks according to the needs of the organization.

Key Responsibilities/Duties – what you will be doing

• Lead department business planning, service model design, business integration; track strategic performance against business goals.
• Acts as a Sales liaison. Attends prospective and existing account meetings representing the Service and Experience Department. Conducts account site visits as needed.
• Oversees the Member and Provider Service RFP response process including the development and management of performance guarantees.
• Creates scalable service models to support account retention and acquisition.
• Partners with IT and Telecom to identify best in class technology/systems to support Service and Experience business goals including leading or supporting telephony platform replacement, CRM and portal procurement/implementation, IVR re-design, system migrations and enhancements, as well as supporting Consumer Engagement/Digital initiatives.
• Creates Service and Experience internal communications to ensure all colleagues are aligned on department goals and objectives.
• Collaborates with all internal business areas to ensure that Member and Provider Service have a “seat at the table” specific to any member and provider corporate initiatives.
• Represents Member and Provider Service on corporate workgroups and cross departmental initiatives.
• Spearheads reward and recognition activities including National Customer Service Week.
• Works collaboratively with departmental peers ensuring that strategic initiatives and goals are achieved.
• Oversees and manages the departmental budget; works closely with line business areas and Financial Planning and Analysis to ensure budget adherence.
• Supports enterprise-wide projects and Service and Experience projects. 
• Partners with Service to translate and evaluate short term business challenges by engaging in problem solving activities (e.g., change management requests –system enhancements, workflow/process improvements, etc.).  
• Leads and manages departmental business continuity activities.
• Ensure proper internal control structures are in place to meet regulatory and industry certification requirements.  Participate in associated compliance audits and interviews. (NCQA, CAHPS, HEDIS, CMS, EOHHS etc.)

Qualifications – what you need to perform the job

Education, Certification and Licensure

• Bachelor's degree related field or equivalent related experience
• Master’s degree in Business Administration preferred

Experience (minimum years required):

• A minimum of 10 years of health care management experience.
• 10 years of experience in a leadership position within a Customer Service Organization

Skill Requirements

• Strategic vision and the ability to translate into tactical plans.
• Exemplary work history with a proven record of success in positions of  progressively greater responsibility managing people and achieving business goals and objectives
• Must understand national/regional/local health care issues and trends. Ability to relate this understanding to current and future markets.
• Ability to develop strong working relationships and to influence key internal and external constituents to meet critical corporate and community business objectives.
• Superior people management skills in attracting, retaining, motivating and developing individuals.
• Outstanding communication skills and the ability to work with all levels within the organization.
• Demonstrated competency in the areas of innovation, influence, negotiation, planning, development and motivation.
• Documented strength in analysis, identification of problems and problem resolution.

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

​Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent.  We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org