Director, Operations; Government Markets

Director, Government Markets Customer Experience

The Government Markets Customer Experience team supports member interactions from our Government Markets members. 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.

In this role, you will:

• 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

Your Knowledge and

Experience:

• 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

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan;
Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and…