Manager, Contact Center Operations

Title: Manager, Contact Center Operations
Reports to: Director, Operations
Classification: Manager
Location: Boston (Hybrid)
Job description revision number and date: v3; 2/20/2025

Organization Summary:

Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast- growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices nationally. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

SCO and One Care Summary

The Senior Care Options (SCO) and One Care programs are health plan programs for dually eligible (Medicare and Medicaid) individuals (“duals”) in Massachusetts. SCO serves eligible beneficiaries aged 65 , while One Care serves duals between ages 21-64. These programs are Fully Integrated Dual-Eligible Special Needs Plans (FIDE-SNP) that integrate Medicare and Medicaid benefits, along with additional supports for enrollees such as integrated care teams, care managers, social supports, etc.

Massachusetts’ Medicaid (MassHealth) agency recently conducted a procurement for health plans to offer products in these two programs, for a five-year term starting January 1, 2026. C3 submitted a bid and was selected in September 2024.

Job Summary:

Under the direction of the Director of Operations, the Manager, Contact Center Operations will oversee day-to-day operational functions of the Call Center and be a key team member in the Operations leadership team. This includes management of the Call Center, grievance resolution processes, and member engagement and enrollment workflows. The Manager, Contact Center Operations will ensure the efficient execution of operational processes and contribute to the success of key initiatives, including the implementation and ongoing operations of the ACO and SCO/OneCare health plan.

This role requires strong leadership, process improvement skills, and cross-functional collaboration to drive operational excellence and ensure compliance with regulatory requirements. The Manager will oversee a team responsible for service delivery and play a key role in optimizing workflows, developing operational policies, and ensuring high-quality experiences for members and providers.

Responsibilities:

• Leads successful day-to-day management, operations, and ongoing development of the Call Center, ensuring caller satisfaction, compliance and meeting regulatory requirements. Serves as the key contact for escalations
• Oversee the grievance process to ensure member satisfaction, ongoing reporting and improvement process with internal and external entities and meeting regulatory requirements
• Responsible for regulatory reporting and compliance across all ACO contracts and SCO/OneCare
• Lead the development, deployment, and management of member-facing materials, including ID cards, handbooks, and informational guides
• Oversee translation, printing, and fulfillment services, ensuring accessibility for all members

• Collaborate with participating health centers and affiliated providers, MassHealth, CMS, and other stakeholders on enrollment, redetermination, member experience, and transaction processes
• Assists in developing and implementing Member Operations workflows and processes for the SCO/OneCare health plan
• Recruits, trains, and manages staff to ensure quality of work, meeting productivity levels, and completion of tasks
• Works closely with the Call Center Supervisor on day-to-day oversight of staff and Call Center functionality
• Work closely with the Director of Operations to ensure departmental Policies and Procedures, Standard Operating Procedures, training materials, and other documentation are complete, accurate, and up-to-date
• May require work-related travel
• Other duties as assigned

Required Skills:

• 5 years of management/supervisory experience in a healthcare setting with operational oversight responsibilities
• Strong commitment to customer service excellence and member engagement
• Meticulous attention to detail with the ability to manage multiple priorities
• Process-oriented mindset with strong analytical and problem-solving skills
• Excellent written and verbal communication skills, including the ability to convey complex information clearly
• Strong project management and organizational skills
• Proficiency in call center software and CRM systems, with a strong understanding of tools for reporting and workforce management
• Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, Outlook)

Desired Other Skills:

• Familiarity with the MassHealth ACO program and Medicaid population
• Familiarity with Federally Qualified Health Centers
• Familiarity with SCO/OneCare and the Medicare population

• Experience working in a health plan call center
• Experience with anti-racism activities and/or lived experience with systemic inequities is highly preferred

Qualifications:

• Bachelor’s Degree preferred
• 5 years of relevant experience

** In compliance with Covid-19 Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **