Director - Call Center

Please no third party candidates for this role.

The Director, Call Center is a senior leadership role responsible for the strategic direction, operational excellence, and regulatory compliance of the member call center operations. This position oversees all aspects of call center performance to ensure a high-quality, compliant, and member-centered experience across the Medicare Advantage Prescription Drug (MAPD) plans. The Director partners closely with executive leadership, Compliance, Technology, and Operations teams to drive service excellence, optimize performance through data and analytics, and support the mission to deliver equitable, accessible healthcare to underserved communities in Texas, Arizona, and future expansion markets.

This position reports to the Chief Operating Officer.

• Provide enterprise-level leadership for the Call Center operations, ensuring alignment with organizational strategy, CMS requirements, and member satisfaction goals.
• Establish and monitor KPIs, service level agreements (SLAs), productivity benchmarks, and quality standards.
• Lead continuous improvement initiatives to enhance workflows, efficiency, and member outcomes.
• Analyze trends, performance metrics, complaints, and grievances to drive data-informed decision-making.
• Directly manage managers and/or senior leaders within the Member call center.
• Foster a high-performance, member-centric culture focused on accountability, engagement, and development.
• Oversee workforce planning, scheduling, skill-based routing, lunch and break coverage, and resource optimization.
• Develop leadership succession plans, training programs, and cross-training strategies.
• Ensure compliance with CMS, HIPAA, state regulatory requirements, and internal policies.
• Oversee call monitoring, quality assurance programs, corrective action plans, and audit readiness.
• Ensure all phone systems, IVR, ACD, digital tools, and member web links function optimally and meet regulatory standards.
• Partner with Compliance and Legal teams to mitigate operational and regulatory risk.
• Oversee call center systems, reporting, dashboards, and analytics to improve performance and the member experience.
• Prepare and present executive-level reports on performance, trends, risks, and improvement initiatives.
• Leverage technology and automation to improve service delivery and scalability.
• Manage relationships with external vendors to ensure contractual SLAs and regulatory obligations are met.
• Collaborate with internal departments to ensure consistent, accurate, and timely member communications.
• Serve as a subject matter expert and escalation point for complex member issues.
• Serve as a role model demonstrating integrity, professionalism, and member advocacy.
• Encourage innovation, accountability, and continuous feedback across teams.
• Perform other duties as assigned in support of departmental and organizational objectives.

• In-depth knowledge of medical terminology and health plan operations.
• Proven ability to lead large, diverse teams and manage through change.
• Advanced analytical, strategic thinking, and problem-solving skills.
• Strong executive-level written and verbal communication skills.
• Proficiency with Microsoft Office (Word, Excel, Outlook, Teams) and call center/CRM systems.
• Ability to present complex information clearly to senior leadership and external stakeholders.
• Integrity and Trust.
• Member/Customer Focus.
• Strategic Leadership.
• Functional & Technical Expertise.
• Written and Oral Communication.
• Critical and Analytical Thinking.

• Bachelor's Degree required (Healthcare Administration, Business, Public Health, or related field preferred).
• Minimum 7-10 years of progressive experience in managed care, health plan member services, or call center operations.
• Minimum 5 years of leadership experience at the manager or senior manager level; director-level experience strongly preferred.
• Demonstrated experience with CMS regulations, Medicare Advantage requirements, grievances/appeals, complaints, and Star Ratings.
• Strong background in call center operations, reporting, analytics, and performance optimization.

Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.

Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.