Summary of Position
• Lead ongoing assessment of customer touchpoints, including target, effectiveness and customer perception of each
touchpoint.
• Collaborate with enterprise‐wide stakeholders to define differentiating customer experience journeys.
• Drive cross‐department root cause analysis of key customer experience abrasion points; oversee definition and execution of
remediation plans.
• Lead the execution of a Quality program across inbound and outbound contact centers and continue to adapt that program
to measure interaction effectiveness, efficiency and experience for our members; directly lead Quality team that will perform
audits and prepare Quality reports.
• Hire, retain and develop talent within the organization and work with senior leadership to define and drive go‐forward
operating model changes based on customer needs and internal capabilities.
• Liaison with senior leadership and provide insights from analysis of Quality audits to enable more effective business decision
making, e.g., product design, network designs, as well as operational improvements
Principal Accountabilities
• Direct Quality team members; define insights needed; work with contact center and Member Hub leadership to
develop remediation plans.
• Define and rollout policies and procedures to staff; direct processes and monitoring needed to ensure that all policies
and procedures are adhered to.
• Hire, retain and develop talent within the organization and work with senior leadership to define and drive go‐forward
operating model changes based on customer needs and internal capabilities
• Lead and drive qualitative and quantitative review of member touchpoints to identify opportunities or pain points that
require remediation or other actions to lessen member impact.
• Responsible to direct analytical resources on performing the needed data mining and insights needed on various
customer journeys.
• Leverage product subject matter expertise, operational knowledge and knowledge of EmblemHealth’s enterprise
technology landscape to drive cross‐departmental solutions and remediation plans to drive member experience
improvements.
• Drive workshops or special sessions to develop remediation plans and recommendations for process improvements,
training guidance, member education, communications etc. based on Quality audits.
• Meet with cross‐enterprise senior leaders to communicate these plans and assign appropriate enterprise ownership.
• Partner with enterprise leadership for bi‐directional sharing of information on ongoing issue resolution and assistance
needed; provide insights for more effective business decision making.
• Perform other tasks and special projects as required or directed.
Education, Training, Licenses, Certifications
• Bachelor’s Degree, preferably in business, healthcare, or social services related field.
Relevant Work Experience, Knowledge, Skills, and Abilities
• 10 – 12+ years of relevant, professional work experience. (R)
• Additional experience/specialized training may be considered in lieu of educational requirements. (R)
• Experience in positions designed to drive member experience and root cause analysis. (R)
• Ability to translate business needs into workplans/technical requirements and communicate them to technical staff. (R)
• 5+ years health care or managed care related experience. (P)
• Excellent leadership skills and the ability to influence line management decisions with data‐driven facts. (R)
• Strong problem solving and analytical skills to be applied to a wide array of business problems and challenges. (R)
• Solid change leadership, facilitation, verbal and written communication, and presentation skills. (R)
• Ability to deal with ambiguity and to interact with all levels of management up to and including executives. (R)
• Self‐starter and independent thinker. (R)
• Strategic and tactical perspective on how to significantly improve operational performance. (R)
• Ability to manage frontline staff on a day‐to‐day basis. (R)
• Proficient with MS Office (Word, Excel, Powerpoint, Teams, Outlook). (R)
• Working knowledge of analysis tools and CRM systems. (P)