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Chief Operating Officer
Lake Lotawana, MO

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The Copley Consulting Group

Director of Calls Oversight

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Job Description

Director, Call Center OversightPosition Summary The Director, Call Center Oversight provides independent enterprise oversight of medical and dental contact center operations across internal teams and vendor partners. This role is responsible for call quality, compliance, member and provider experience, operational performance, vendor accountability, risk management, and continuous improvement. The Director serves as a strategic leader, providing executive leadership with objective assessments of performance, compliance, operational risks, and service excellence initiatives. Key ResponsibilitiesEnterprise Oversight & Governance Lead the enterprise call center oversight strategy for medical and dental operations. Establish governance frameworks for internal and outsourced contact centers. Provide executive reporting on operational performance, risks, and improvement opportunities. Serve as the senior escalation point for significant service and operational issues. Vendor Management Oversee third-party call center vendors to ensure compliance with contractual and service requirements. Lead vendor governance reviews and performance discussions. Drive corrective action plans and monitor vendor accountability. Validate improvements through audits, reporting, and operational reviews. Quality & Compliance Direct enterprise call quality monitoring and audit programs. Ensure accurate and compliant communications related to benefits, claims, eligibility, and provider services. Oversee compliance with HIPAA, CMS, OPM, FEHB, accreditation, and internal policies. Identify quality risks and implement corrective actions. Member & Provider Experience Monitor customer experience, complaints, grievances, appeals, and escalations. Identify service gaps and improvement opportunities. Support initiatives that improve first-call resolution and overall satisfaction. Promote a customer-focused culture across all service operations. Performance & Risk Management Monitor key performance indicators, including: Service Level Average Speed of Answer (ASA) First Call Resolution (FCR) Abandonment Rate Transfer Rate Call Quality Scores Complaint and Escalation Trends Member and Provider Satisfaction Metrics Identify operational risks and require data-driven remediation plans. Lead governance for significant operational incidents and escalations. Partner with Operations, Claims, Benefits, Compliance, Training, Technology, and Vendor teams to resolve complex issues. Qualifications Required Bachelor's degree or equivalent experience. 10+ years of contact center, healthcare operations, quality, compliance, or customer experience leadership experience. Experience managing vendor relationships and service-level performance. Strong knowledge of quality assurance, compliance programs, risk management, and operational analytics. Proven ability to present recommendations and performance insights to executive leadership. Preferred Healthcare, health plan, or insurance industry experience. Knowledge of HIPAA, CMS, FEHB, and related regulatory requirements. Lean Six Sigma, Quality, Compliance, or Operational Excellence certifications. Medical, dental, and vision insurance are available to qualified candidates who meet eligibility requirements.

Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance