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Director of Customer Service & Call Center Operations

The Director of Customer Service & Call Center Operations is a senior leader responsible for building and leading a high-performing, culturally competent contact center serving a predominantly Asian senior Medicare population within a fully delegated, full-risk PCP IPA / MSO environment.

This role oversees patient, provider, and broker service experience while driving operational excellence, team development, and value-based care outcomes.

Key Responsibilities

Patient & Partner Experience Leadership

• Champion a patient-first, culturally aligned service model for Asian elderly patients and caregivers
• Ensure high standards for empathy, clarity, first-call resolution, and timely access to care
• Oversee service delivery for patients, PCP practices, specialists, and broker partners
• Translate feedback and complaints into measurable service improvements

People Leadership & Culture

• Lead, coach, and develop managers and frontline customer service teams
• Foster a respectful, accountable, and service-driven culture
• Oversee onboarding and training focused on Medicare Advantage, cultural sensitivity, and service excellence

Operations & Performance Management

• Oversee daily contact center operations (phone, digital, portal)
• Manage KPIs including CSAT, NPS, FCR, ASA, abandonment rate, and quality scores
• Optimize staffing, workforce planning, and seasonal readiness (AEP/OEP)
• Use data and dashboards to drive continuous improvement

Value-Based Care & Clinical Partnership

• Align contact center workflows with care gap closure, AWVs, preventive screenings, and post-discharge outreach
• Partner with Clinical, Quality, and Care Management teams to improve outcomes and member retention

Compliance & Systems

• Ensure compliance with HIPAA, CMS, and Medicare Advantage regulations
• Partner with IT to optimize telephony, CRM, and contact center technologies

Qualifications

Required:

• Bachelor’s degree in Healthcare Administration, Business, or related field preferred
• 7+ years of healthcare customer service or call center leadership experience
• Experience in Medicare Advantage, managed care, IPA/MSO, ACO, or value-based care environments
• Proven success leading large frontline service teams
• Bilingual in English and at least one Asian language (e.g., Korean, Chinese, Vietnamese, or Tagalog) – Required
• Strong understanding of culturally competent service for senior populations

Preferred:

• Experience serving Asian or immigrant senior populations
• Familiarity with EMR, CRM, and workforce management systems
• Lean, Six Sigma, or Service Excellence training

Success Measures

• Improved patient, provider, and broker satisfaction
• Reduced escalations and complaints
• Improved access metrics and first-contact resolution
• Strong employee engagement and retention

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!

Hybrid: Applicants must be a California resident as of their first day of employment.

PRINCIPAL RESPONSIBILITIES:

Member Services Representatives (MSR) are the first point of contact for our members' primary contact with the Alliance for both routine and complex member issues with the goal of delivering excellent customer service to our customers. The position is responsible for answering a high volume of inbound and outbound calls in a timely manner. Respond to all communications coming into Member Services in the form of email, fax, letters, chat and phone calls. Timely responses to all member communication are essential. Must effectively prioritize and flex the workload as new communication and tasks are submitted. Identify the caller's needs, clarify information, research issues, and provide solutions and/or alternatives whenever possible. Accurately and consistently document all conversations in the electronic database. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly staffed classification and work is expected to be performed minimally at the MRS II level. However, the initial selection will be made at the entry level MSR I. Our more advanced level position of the series is the MSR III who will be required to perform a variety of complex matters.

Member Services Representatives are under the direction of a Member Services Supervisor, Manager and Director, and service our members through our call center as well assisting other departments with responses to member issues by initiating communication between departments to ensure action, cooperation, and compliance of managed care operations.

Member Services Representative I

This position which requires the ability to work as a team player within the Alliance and with external contacts, make sound judgments based on analysis of information, be an effective communicator, active listener and balance advocacy for the member with the policy provisions such as plan policies, EOC, regulatory guidelines, and DMHC/DHCS rules and regulations. The MSR provides courteous, professional, and accurate responses to incoming inquiries regarding network, plan benefits, eligibility, authorizations, plan services and guidelines, as well make decisions with the goal of ensuring member satisfaction and retention. The MSR performs a variety of complex functions and is also responsible for maintaining accurate and complete inquiry/grievance records in the electronic database. Maintains compliance with DMHC regulatory requirements and DHCS contractual obligations. MSR I staff who demonstrate proficiency in meeting, maintaining and exceeding principal performance objectives and metrics may be eligible to be promoted to a Member Services II or III role. Member Services Representative I staff may be eligible for promotion to Member Services Representative II or III positions once they have worked as a MSR I for a minimum of 12 months to be proficient with program and system knowledge in addition to meeting performance matrix requirements.

Principle duties and responsibilities

* Serve as the primary contact for members, providers and others for questions related to claims, benefits, authorizations, pharmacy, member eligibility and other questions related to Alameda Alliance and provide accurate, satisfactory answers to their inquiries or concerns.

* Respond to and resolve member service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility, claims, behavioral health, and care coordination.

* Answer incoming calls, emails, chats, and other requests for assistance in a timely manner in accordance with departmental performance targets and provide excellent customer service while doing so. May include assisting members in person.

* Recognize and understand the difference between calls that require quick resolutions and calls which will require follow-up and handle each appropriately.

* De-escalate situations involving dissatisfied customers, offering patient assistance and support.

* Accurately document all contacts per department standards/guidelines in the Customer Relationship Management (CRM) system.

* Accurately and consistently document (electronic database) and resolve Exempt Grievances (any expression of dissatisfaction that are not coverage disputes, disputed health care services involving medical necessity, or experimental or investigational treatment and that are resolved by the next business day following receipt).

* Interface with Grievance and Appeals, Claims, Enrollment, IT, Network Management, Pharmacy, Authorizations, and other internal departments to provide Service Excellence to our members.

* Help guide and educate members about the fundamentals and benefits of managed health care topics, to include managing their health and well-being by selecting the best benefit plan service options, maximizing the value of their health plan benefits, and choosing a quality care provider.

* Intercede with care providers (doctor's offices) on behalf of the member, assisting with appointment scheduling; connect members with internal Case Management Department for assistance as needed.

* Assist members in navigating , the Member Portal, and other health care partner online resources and websites to encourage/reassure them to use self- service tools that are available.

* Manage any issues through to resolution on behalf of the member, either on a single call or through comprehensive and timely follow-up.

* Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues.

* Provide education and status on previously submitted pre-authorizations or pre- determination requests for both medical and pharmaceutical benefits.

* Meet the performance goals established for the position in the areas of compliance, efficiency, call quality, member satisfaction, first call resolution, punctuality, and attendance.

* Always maintain a professional level of service to members.

* Always maintain confidentiality of information.

* Consistently support the Alliance's approach to Service Excellence by adhering to established department and company standards for all work-related functions.

* Interact positively with all Alliance Departments.

* Accurately and consistently document (electronic database) and resolve Exempt Grievances (any expression of dissatisfaction that are not coverage disputes, disputed health care services involving medical necessity, or experimental or investigational treatment and that are resolved by the next business day following receipt).

* Process MS Dept projects

* Serve as a back-up to manage the escalated calls.

* Perform other duties as assigned.

ESSENTIAL FUNCTIONS OF THE JOB

* Contacts: Receive, manage, and document telephone calls, emails, and other sources of contacts from members, potential members, and providers, and explain health plan benefits and plan rules. Describe the types of services the Alliance offers to the Member within the managed care system. Provide clarification about issues regarding patient and physician rights and how the plan operates.

* Conflict resolution: Resolve member problems/conflicts by convening with other departmental staff as needed.

* Member communications: Create and/or mail appropriate member materials and communications as needed.

* Computer: Perform ongoing data entry which assists in the maintenance of the Member Services department database to ensure data integrity.

* Comply with the organization's Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.

PHYSICAL REQUIREMENTS

* Constant and close visual work at desk or computer.

* Constant sitting and working at desk.

* Constant data entry using keyboard and/or mouse.

* Constant use of multi-monitor setup

* Frequent use of telephone and headset.

* Frequent verbal and written communication with staff and other business associates by telephone, correspondence, or in person.

* Frequent lifting of folders, files, binders, and other objects weighing between 0 and 30 lbs.

* Frequent walking and Standing

Number of Employees Supervised: 0

MINIMUM QUALIFICATIONS:

* Bachelor's degree or equivalent experience preferred.

* High school diploma, GED required.

* The ability to speak and understand-bilingual: Spanish/English, Cantonese/English, Vietnamese/English, Tagalog/English are required as designated.

* A bilingual proficiency exam will be administered to ensure the candidate possesses the appropriate skill level to meet requirements. The successful candidate must score 90% or higher.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

* Minimum one year of direct customer service experience. Call center experience and managed care experience a plus

* Experience determining eligibility for financial assistance, insurance benefits, unemployment and/or other social services programs.

* Demonstrated knowledge expert of AAH Member Services policies and procedures

* Consistent record of meeting, maintaining, or exceeding monthly Departmental performance metrics.

* Consistent track record of documenting Service Requests accurately and clearly and monitoring open Service Requests to ensure responses and closure.

* Consistent record of high quality of work as demonstrated through call and documentation auditing, appropriate Call Disposition coding, as well as an overall acceptable monthly Member Satisfaction Survey result as assessed by Member Services Quality Specialist, MS Trainer and Member Services Supervisor.

* Demonstrated proficiency in current Customer Relationship Management (CRM) tool, phone system software Quality Management Solution, Pharmacy Benefits Management applications (PBM), Interpreter vendor scheduling software, delegate portal solutions and the Alliance's Member portal.

* Demonstrated ability to effectively handle the department's key special projects: Member Portal Request Processing, Kaiser PTE Requests, PCP retroactive and same month requests.

* Demonstrated ability to help members face-to-face in the field and/or at the Alliance offices (walk-ins). Also highly skilled at handling issues related to member bills, transportation set-up and benefit coordination with providers and pharmacy needs.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

* Ability to prioritize and adapt to changing situations in a calm and professional manner.

* Ability to maintain composure in stressful situations.

* Excellent problem-solving skills

* Ability to exhibit cooperation, flexibility, and provide assistance when talking to members, providers, and staff.

* Skill in basic data entry

* Ability to type 40 net words per minute: multi-task

* Manual dexterity to operate telephone, computer keyboard equipment.

* Speak English proficiently, clearly, and audibly.

* Memorize and retain information quickly; meet physical requirements

* Spell correctly

* Learn the policies, regulations, and rules applicable to business operations.

* Follow instructions, reason clearly, analyze solutions accurately, act quickly and effectively in emergency situations; operate office equipment including computers and supporting word processing, spreadsheet, and database applications.

* Excellent phone etiquette and ability to communicate clearly and concisely, both orally and in writing.

* Excellent interpersonal skills with the ability to interact with diverse individuals and flexibility to customize approach to meet all types of member communication styles and personalities.

* Strong verbal and written communication skills.

* Demonstrated ability to quickly build rapport and respond to members in a compassionate manner by identifying and exceeding member expectations (responding in respectful, timely manner, consistently meeting commitments).

* Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member.

* Must be self-motivated and able to work with minimal supervision

* Must be team-oriented and focused on achieving organizational goals.

* Proficient problem-solving approach to quickly assess current state and formulate recommendations.

* Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions which members can understand and act upon.

* Proficient conflict management skills to include ability to resolve issues during stressful situations and demonstrating personal resilience.

* Ability to work regularly scheduled shifts within the Alliance's hours of operation including the training period, with scheduled lunches and breaks, flexibility to adjust daily schedules; and to work over-time and/or weekends as needed.

* Medical terminology knowledge preferred

* Ability to work within a broad systems perspective

* Experience in use of various computer systems software as well as Microsoft Windows, and Microsoft Suite, especially Outlook, Word, Excel.

* Must have reliable and stable internet connection for remote work (50-100 Mbps download speeds).

Employees who interact with members of the public may be required to be tested for Tuberculosis and fully vaccinated against COVID-19 and influenza. Successful candidates for those positions/ classifications may be required to submit proof of vaccination against influenza and/or COVID-19, a negative Tuberculosis test, or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not present proof of vaccination until instructed to do so by the Human Resources department.

SALARY RANGE $22.88-$34.33 HOURLY

The Alliance is an equal opportunity employer and makes all employment decisions on the basis of merit and business necessity. We strive to have the best-qualified person in every job. The Alliance prohibits unlawful discrimination against any employee or applicant for employment based on race, color, religious creed, sex, gender, transgender status, age, sexual orientation, national origin, ethnicity, citizenship, ancestry, religion, marital status, familial status, status as a victim of domestic violence, assault or stalking, military service/veteran status, physical or mental disability, genetic information, medical condition, employees requesting accommodation of a disability or religious belief, political affiliation or activities, or any other status protected by federal, state, or local laws.

Physical Therapist (PT) – Flexible, Independent, Patient-Focused

If you’re a Physical Therapist who values autonomy, efficiency, and real work-life balance, this opportunity was designed for you.

Distinctive Therapy Services is a clinician-led therapy group built for PTs who want to focus on patient care—not productivity quotas, corporate bureaucracy, or unnecessary administrative work.

We’re looking for confident, self-motivated clinicians who manage their time well and want the freedom to practice without corporate constraints.

True Autonomy – Manage your own schedule, caseload, and coverage area

No Corporate Red Tape – No productivity quotas, micromanagement, or endless meetings

Efficient Documentation – Streamlined charting using TherapyBoss

Minimal Administrative Burden – We handle coordination so you can focus on care

Flexible Work Options – Full-time, part-time, PRN, or contract roles

Clinician-Led Culture – Built by therapists, for therapists

• Perform in-home physical therapy evaluations and treatments

• Provide high-quality, one-on-one patient care

• Complete documentation efficiently using TherapyBoss EMR

• Communicate with referring home health agencies as needed

• Practice without pressure to “hit productivity numbers”

• Active Illinois Physical Therapist license

• 1+ year experience in home health, outpatient, SNF, or hospital settings preferred

• Comfortable working independently and managing your schedule

• Strong communication and organization skills

• Comfortable with electronic documentation

Bonus Qualifications

• Bilingual (Spanish, Tagalog, Vietnamese, etc.)

• Experience with orthopedic, neurologic, or post-operative patients

• Choose your own hours and service area

• No minimum caseload requirements

• Full-time, part-time, PRN, or contract opportunities

• Competitive per-visit and hourly compensation

• Flexible schedule

• License reimbursement

• Referral program

• Opportunities for advancement

• Looking for an Assistant Property Maintenance Manager This role requires someone who knows how to do the work and how to lead it.
• Conduct timely, constructive performance evaluations
• Assess property conditions and determine required maintenance/repairs
• Plan vendor assignments and project schedules
• Ensure maintenance and repair work is completed correctly and on time
• Assist with departmental budgeting and repair cost estimates
• Enter and code work orders and invoices in Yardi
• Maintain strong professional relationships with vendor partners
• Partner closely with Property Management and Leasing teams on maintenance needs
• Review, reconcile, and approve invoices and vendor bids
• Lead and facilitate meetings to coordinate maintenance activities and project updates
• Support additional departmental needs as assigned

Required Experience & Skills

This is both an administrative leadership role and a maintenance savvy role.

• Experience:
• Minimum 3+ years of maintenance experience
• Strong knowledge of:
• Plumbing
• Heat (steam)
• Electrical systems
• Prior people management or team leadership experience is critical

• Core Skills:
• Strong delegation, coordination, and follow through
• Excellent analytical and problem solving ability
• Highly organized with strong attention to detail
• Comfortable managing multiple priorities in a deadline-driven environment
• Clear, confident written and verbal communication
• Able to document processes and maintain accurate records

• Team Overview:
• Oversees 2 team leads
• 8 administrative coordinators
• Total direct/indirect oversight: ~10 people
• Union vendors handle plumbing, landscaping, and related services

• Systems:
• Required: Microsoft Office, Yardi
• Preferred: Zendesk,

• Language Requirements
• Bilingual is strongly preferred
• Spanish is ideal
• Mandarin, Tagalog, Vietnamese, and other language abilities are also highly valued

• Education
• High school diploma or equivalent required
• Associate or Bachelor’s degree preferred

Soft Skills & Leadership Profile (Very Important)

• Looking for someone who takes ownership and accountability
• Is proactive and detail driven
• Leads with integrity and follow through
• Communicates clearly and consistently
• Is a leader, not just a manager

“Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act

• Los Angeles City Fair Chance Ordinance

• Los Angeles County Fair Chance Ordinance for Employers

• San Francisco Fair Chance Ordinance”

Summary:

The competent Nurse, in the same or similar clinical setting, practices independently and demonstrates an awareness of all relevant aspects of a situation. Provides routine and complex care, with the ability to on long-range goals or plans. Continues to develop the ability to cope with and manage contingencies of clinical nursing. Makes appropriate assignments and delegates to other care providers as a means to help manage the clinical situation.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Consistent with the ANA Scope and Standards of Practice, provides nursing care utilizing the nursing process, including assessment, diagnosis, planning, intervention and evaluation for assigned patients.
• Addresses increasingly complex psychological, emotional, cultural, and social needs of patient and families in accordance with their level of practice.
• Using the appropriate protocol, administers medications and treatments;
  monitors for side-effects and effectiveness of the treatment prescribed.
• Documents patient history, symptoms, medication, and care given.
• Assess learning needs and provides education to patients, family members and/or care givers;
  identify issues and resources.

CORE COMPETENCIES

Standard I: Utilizes the Nursing Process

• Uses critical thinking skills to assess the basic physical, psychosocial, social, cultural, spiritual, and development needs of patient and families
• Communicates findings to appropriate healthcare team members
• Develops and uses a specific plan of care and modifies it to meet individual patient needs using evidence-based practice
• Implements patient care and therapeutic procedures;
  monitors and documents progression of treatment and teaching goals
• Evaluates the care and treatment(s) provided to the patient and the patient response to the care and treatment(s)
• Performs timely reassessment and documentation
• Must be able to perform unit-specific competencies based on the specific patient care need for the designated unit's patient population

Standard II. Patient Throughput & Patient Flow Process

• Anticipates and plans for admission/discharge/transfer needs to facilitate patient flow
• Utilizes appropriate systems of communication and tools to facilitate the discharge process
• Coaches on tools and techniques for checking, cross checking and validating orders to ensure accuracy

Standard III. Unit Operations

• Plans, directs, and evaluates the overall nursing care and functions in a particular nursing unit during an assigned shift
• Demonstrates good stewardship in proper use and maintenance of equipment and Supplies
• Assesses departmental staffing needs;
  actively participates in resourcing efforts.
• Educates and trains others on the operations, ethics, and regulations within the industry

Standard IV. Safe Practice/Quality Care/Regulations

• Incorporates patient safety practices/guidelines to promote a safe environment resulting in positive patient outcomes
• Demonstrates accountability for nursing research and quality improvement activities
• Provides evidence-based nursing care
• Communicates patient information effectively across the continuum of care
• Educates and trains others on the operations, ethics, and regulations within the industry
• Knowledge of federal, state and local healthcare-related laws and regulations;
  ability to comply with these in healthcare practices and activities

TECHNICAL COMPETENCIES

Clinical Policies and Standards

• Follows a specific set of standards and associated clinical procedures
• Analyzes policy and standards documentation and ensures organizational compliance
• Provides feedback for improvement of procedures
• Assists in the development and implementation of specific procedures
• Works with control and monitoring mechanisms, tools and techniques

Health Information Documentation

• Shares experiences with maintaining paper and electronic patient documentation
• Walk through the steps and procedures for receiving, validating and updating patient records
• Describes the flow of information between various stations or units
• Discusses the functions, features and document flow of electronic documentation
• Transcribes verbal orders;
  explains techniques forensuring their accuracy
• Explains health information documentation best practices and their rationale across health care practices

Medical Equipment

• Describes experience with basic medical equipment used in own unit or facility
• Uses standard diagnostic tools and techniques to resolves common equipment problems
• Educates patients about the appropriate use of home medical equipment
• Ensures that all equipment and related supplies are in proper working order prior to use to ensure patient safety
• Inspects, troubleshoots and evaluates incoming equipment

Medical Order Processing

• Shares experiences with processing medical orders for one or more groups of patients or conditions
• Describes functions and features of the system used to enter, validate, update and forward medical orders
• Discusses common errors, their sources and procedures for correcting
• Explains considerations for entering and following standing orders
• Differentiates between standing orders and preprinted orders and considerations for each

Patient Chart Reading and Interpretation

• Describes experiences in reading and interpreting patient charts for patients on unit and under own care
• Reviews patients’ charts for completion and accuracy;
  identifies and alerts to mistakes or omissions
• Recognizes unexpected readings and alerts nursing or medical staff
• Relates examples of mis-readings or misinterpretations and lessons learned
• Reviews, discusses and validates own interpretation with others

Patient Safety

• Shares experiences with ensuring safety for one or more patient groups or settings
• Explains key features of safety guidelines and procedures for those groups and settings
• Listens and responds to safety inquiries from patients and family members
• Recognizes and addresses physiological and psychological signs of problems
• Describes considerations for patients who can cause to harm to self, versus harm to others
• Utilizes appropriate systems to document misses and near misses, participates in immediate investigating, analysis and reporting in real-time

Job Requirements:

Education/Skills

• Bachelor of Science Degree in Nursing, preferred

Experience

• 1 year of experience in the related nursing specialty preferred

Licenses, Registrations, or Certifications

• BLS required
• RN License in state of employment or compact

In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.

Work Schedule:

MULTIPLE SHIFTS AVAILABLE

Work Type:

Full Time