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At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

The Director, Customer Service enhances business performance by providing oversight of Customer Service and Member Appeal & Grievance Department and call center performance. Collaborates with the Chief Operating Officer, to plan, direct and manage all assigned areas of the Customer Service/Member Appeal and Grievance Department. Responsible for evaluation and resolution of problems and outcomes of assigned Customer Service and Member Appeal and Grievance activities.

This is an onsite role based in Grand Junction, CO.  

Primary Responsibilities: 

• Oversee the operations of the Customer Service and Member Appeal and Grievance Department at C&S CO health plan. Direct full day-to-day oversight and decision making of both teams, including management of personnel resources, call volume inventory, workflow assessments, and evaluation. This includes member and provider calls, walk-ins, voice mails, and chat
• Represent C&S CO health plan for both Customer Service and Appeals and Grievance for State calls and audits as required
• Accept responsibility for results of call center performance for both member and provider calls as well as member and provider walk ins for all lines of business at C&S CO health plan for MD/RAE (Regions 1 & 2)/CHP/PRIME and for both member and provider at the enterprise
• Accept responsibility for results of Member Appeal & Grievance metrics and functions at C&S CO health plan and the enterprise for MD/RAE (Regions 1 & 2)/CHP/PRIME
• Select, train, develop, appraise, and motivate qualified staff to effectively carry out department process functions.  Appropriately train, mentor and utilize supervisors. Take corrective action as necessary on a timely basis and in accordance with company policy
• Provide effective communication within the department and with other internal and external departments, Senior Leadership and State Agencies
• Works with the COO and other leaders at the enterprise to develop and modify processes in accordance with corporate goals and contractual performance standards. Implement process changes, new services or other modifications based on results of market research, availability of new technologies, and/or other input
• Act as a backup to the enterprise call center for both member and provider calls for approximately 15% of overflow calls for C&S CO to ensure that contractual SLA's are met
• Act as a backup to the enterprise for Appeals and Grievances to ensure state contractual requirements as well as NHP SOW requirements are met
• Develop and monitor goals, critical indicators, outcome measurements, financial performance and resource requirements related to the assigned Customer Service and Member Appeal and Grievance functions. Monitor timeliness and accuracy of work products in both the assigned team functions
• Prepare monthly, quarterly, and annual performance standards reports for MD, CHP, and DSNP for the State of CO for RAE Regions 1 and 2 (NHP) adhering to contract standards
• Work with the Director of ASO Ops to ensure delivery of timely reports for both call center and A&G for RAE Region 2 to ensure contractual timelines are met
• Determine and implement corrective action necessary to ensure successful completion of goals. Analyze reasons why goals are not met if necessary and adjust appropriately
• Responsible for oversight of purchasing materials and supplies for mailroom, and payment of invoices including support for other departments
• Responsible for the printing, scanning, copy and mail service functions
• This position may require travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications: 

• Bachelor's degree in Business Administration, Healthcare Management, or the combination of education and experience that would enable performance of the full scope of the position
• 5 years related progressive experience in a service center environment
• Experience leading staff to provide exceptional customer service
• Demonstrated solid people management skills and a detailed knowledge of Customer Service departmental processes and functions
• Demonstrated ability to lead
• Proven ability to work collaboratively with diverse individuals and functions at all levels of the organization. Requires an understanding of general business, health care, and health coverage issues
• Reside locally to Grand Junction, CO 

Preferred Qualification:  

• 2 years of management experience 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.