**Description**

Join our team of dedicated professionals who are committed to ensuring our clients can provide affordable health benefit solutions for their employees.

Pinnacle Claims Management is a 3rd party administrator that provides health benefits administration and related services to companies that self-fund their insurance. We are also a contracted partner with CCSB.

Pinnacle is independently owned and has been serving clients for 20 years. We are also part of the Western Growers Family of Companies.

**Job Description Summary**

The Director of Customer Service will partner with both internal and external stakeholders to develop operational improvements, design project plans and work with relevant vendors to advance client satisfaction, improve service, quality, and colleague engagement. This crucial and visible role is responsible for optimizing the current customer service function and devising a strategy for the future by developing talent, measurements, and systems that will foster continuous improvement resulting in a world-class customer experience and foster a strong community in the Companys brand. The position will focus on maintaining and improving three core areas of customer service operations. These areas include: Covered Californias agent experience, using analytics and reporting to define metrics and expectations geared towards individual and department growth; the Customer Experience, by improving first contact resolution and reducing customer effort in interacting with the Call Center team; and system opertations agility by optimizing existing platforms and providing resources geared towards maximizing efficiency. The incumbent will lead both people and processes in building, planning and implementing a multi-channel contact center environment, exceeding customer success metrics, driving process improvements and offering innovative solutions to ensure an excellent customer experience. The position reports to the Assistant Vice President of Operations, has three supervisors and a business analyst reporting to it.

**Qualifications**

* Bachelor's degree in healthcare, business, related field, or equivalent experience, plus seven (7) or more years of working with groups in various disciplines e.g. employee health benefit claims, pharmacy benefits, and State Health Exchanges in an influencial planning and management role/s in a healthcare or insurance environment preferred.

* Extensive experience managing, designing and building multi-channel customer-centered experiences e.g. email, online self-service, chats etc. from the ground up.

* Good working knowledge of applicable technologies, laws, regulations and industry practices.

* Proven management and/or relationship management experience at a senior, strategic level role.

* Experience as process improvement practitioner/leader in recognized process improvement business models, analyzing complex datasets while keeping big-picture strategic goals in mind.

* Proven track record of building high performing teams and developing key talent.

* Experience leading and prioritizing large-scale projects.

* Proven ability to serve as a change agent/champion to drive organizational transformation in alignment with strategy and vision.

* Ability to align systems, programs and people with the company strategy and culture.

* Demonstrated ability to navigate through ambiguity and provide a structured problem-solving approach to challenges.

* Experience streamlining processes and communication across remote teams.

* Strong analytical skills and applied knowledge of problem solving and solutions.

* Experience working within a customer relationship management system (CRM), Interactive Voice Response (IVR) or similar systems.

* Proficient in MS Office, specifically Excel, Outlook, Word and PowerPoint.

**Duties And Responsibilities**

*Customer Service Operations*

* Facilitates and drives a service culture to achieve growth and retention targets, improve service and customer satisfaction.

* Establishing a learning culture where professional improvement amoung staff is highly regarded, expected, reinforced and rewarded.

* Creates functional strategies and specific objectives for customer service functions. Develops budgets, policies & procedures to maximize employee production and support the functional infrastructure and compliance of regulatory entities including Covered California, the Department of Insurance (CDI), and the Department of Labor (DOL) requirements.

* Oversees the training, hiring, development and quality of all customer service employees and ensures that each possesses the necessary skill sets to accurately communicate and support company initiatives while providing knowledgeable and efficient service to customers.

* Support the organization by providing actionable intelligence on market trends, customer insights, and competitive positioning. Using data to create meaningful reports and presentations that clearly identify and simplify the impactful insights, combined with business implications and strategic and tactical options.

* Develop, track, and report on customer service objectives and key performance indicators (KPI) results e.g. First Contact resolution, Frictionless Interactions, Productivity, etc.

* Monitors KPIs to ensure customer service and operational performance standards are being met and ensuring corrective action is taken for those areas not meeting performance standards.

* Maintain integrity of customer data and accurately record all complaints, generic responses and other data in the designated databases.

* Defines, negotiates and directs the effective utilization of resources and equipment needs in line with service specifications, budget requirements, business objectives and service level agreements.

* Monitor customer complaints via phone, chat, email and consistently help create solutions that benefit all parties even in the most complex, sensitive and/or adversarial situations.

* Maintains strategic ties with key departments (human resources, sales, marketing, operations, AP/AR, IT) and vendors to ensure there is a smooth transition in any policy, procedure, rule and/or practice change or adjustment.

* Develops and leads end-to-end projects and ensure on-time delivery of critical initiatives.

* Solve complex customer service issues and proactively head-off negative, service spikes.

* Leads the translation of a variety of data into meaningful opportunities, provides insights based on a deep knowledge of company, market environment, analytics and department progress in the form of formal oral and written presentations to the senior leaders, department managers/directors, and vendors/clients

* Assumes the role of key spokesperson for the Customer Service Department.

*Continuous Process Improvement*

* Collaborates with and actively coaches department supervisors, systems analysts, manager and staff to develop and implement strategies to improve customer service experience.

* Drives a culture of accountability, continuous improvement, and personal excellence with Customer Service team and across Operations

* Stays current on new technology and evolving industry trends impacting customer care; create initiatives to consistently improve our ability to service customers. Develop new practices and tools to service clients and drive efficiency.

* Develop and implement strategies to deploy digital solutions enabling customers to obtain information without human intervention.

* Partnering with senior leadership, continuously evaluate progress and identifies and mitigates barriers to success in order to achieve targeted results

* Manage metrics, performance criteria, policies and procedures to continuously improve call center productivity.

* Track/monitor and use customer insight and root cause analytics to identify company-wide improvement opportunities and marketing success.

* Drive initiatives to increase customer self-service and first contact r