Director Operations Member Services

$112,000 - $145,000/Yr

Kaiser Permanente - San Diego, CA

Full-time - Director

San Diego, CA

5,001-10,000 employees

Ambulatory Health Care Services

About the position

The Director of Operations Member Services at Kaiser Permanente is responsible for providing leadership and strategic direction to the Local Member Services professional staff across multiple sites. This role involves overseeing daily operations, managing case processing, resolving issues, and ensuring high-quality service for both internal and external customers. The director will collaborate with regional and local leadership to minimize financial risks and ensure contract integrity, while also focusing on member retention and satisfaction.

Responsibilities

• Provides leadership and oversight for member services at designated facilities, including budgetary and compliance management.
• Identifies member pain points and collaborates with area leaders to drive service improvements and increase member satisfaction.
• Acts as a liaison with the medical group to develop programs and improve member experience.
• Manages high-risk issues with timely communication to medical facilities.
• Provides ongoing reports and recommendations related to data analysis and service concerns.
• Oversees daily operations of the member services department, linking with auditing and training.
• Identifies member-system conflicts to prevent liability and retain satisfied members.
• Hires, supervises, and develops staff handling sensitive member issues.
• Creates a team atmosphere that promotes self-directed work and staff empowerment.
• Educates facility departments and physicians on health plan products and member issue resolution.
• Fosters a service-oriented work environment focused on quality and innovation.

Requirements

• Minimum eight (8) years of management/leadership experience in a complex healthcare or service-oriented organization.
• Minimum three (3) years of experience in customer service improvement and process redesign.
• Minimum three (3) years of experience working with accreditation and regulatory agencies.

Nice-to-haves

• Excellent investigation, problem solving, and documentation skills preferred.
• Master's degree preferred.

Benefits

• Competitive compensation
• Comprehensive medical coverage
• Retirement plans
• Wellness programs
• Professional development opportunities