Director, Customer Care Operations

About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.

Location: Remote (U.S. only)

Position Summary

The Director, Customer Care Operations is accountable for the operational performance, service quality, and continuous improvement of Customer Care. This leader sets direction for how work flows through the organization, owns the operating metrics and results that matter to members, clients, and the business, and leads managers and cross-functional partners to deliver scalable, efficient, and high-quality service. This leader directly manages two Customer Care Managers and has leadership accountability, through 12 Supervisors, for an organization of approximately 150-200 pharmacy technicians and customer service agents. The Director drives Customer Care’s priorities for policy, quality assurance, training, and compliance in partnership with the enterprise leaders who own those disciplines, ensuring they are embedded in day-to-day operations and translated into measurable results.

Position Responsibilities

Operational Leadership and Performance

• Lead Customer Care operations through two Managers and 12 Supervisors, with accountability for approximately 150-200 pharmacy technicians and customer service agents delivering member, pharmacy, and client service, frontline execution, and issue resolution.
• Own operational performance against service, quality, efficiency, and member experience goals; establish targets, monitor results, and hold the organization accountable for outcomes.
• Use call trends, escalations, quality results, and operational data to identify root causes, prioritize improvements, and drive measurable performance gains.
• Partner with Workforce Management and Operations leadership on forecasting, staffing, scheduling, and capacity planning to meet demand and service commitments.
• Accountable for Customer Care Operations budget performance, managing labor costs against forecast in partnership with Workforce Management.
• Build and present executive-level reporting, insights, and business cases that inform staffing, investment, and operating-model decisions.

Process Improvement and Efficiency

• Lead the identification, design, and implementation of workflow and process improvements that reduce friction, eliminate rework, and increase first-contact resolution.
• Oversee operational process documentation, job aids, and workflow guidance so frontline teams have clear, consistent, and current direction.
• Direct escalation and issue-resolution efforts by researching root cause, aligning stakeholders, and ensuring sustainable fixes are implemented.
• Lead knowledge management efforts to ensure agents, supervisors, and leaders have accurate and accessible information to resolve inquiries efficiently.
• Identify opportunities to leverage technology and automation, including Salesforce CRM and Salesforce Knowledge, phone systems, and the Member Portal, to improve service and productivity.

Cross-Functional Partnership: Policy, Quality Assurance, Training, and Compliance

• Policy and Compliance: Partner with Policy, Compliance, and Legal leaders to ensure regulatory and legislative requirements are reflected in Customer Care operations; champion Customer Care’s needs and translate new or changed requirements into practical, operational procedures.
• Quality Assurance: Partner with Quality Assurance and Compliance leaders to align quality standards and call grading criteria with operational priorities; use quality results to drive coaching, scorecards, and targeted performance improvement for Customer Care.
• Training: Partner with Training leaders to identify skill and knowledge gaps from operational data, shape training content for Customer Care, and reinforce adoption of new processes, systems, and service expectations on the floor.
• Audit Readiness: Maintain operational readiness for audits and regulatory reviews, and drive timely closure of Customer Care corrective actions, in partnership with Compliance and Legal.

People Leadership

• Lead, coach, and develop managers and supervisors; build a strong leadership bench and a culture of accountability, engagement, and continuous improvement.
• Maintain and evolve quality and agent scorecards and performance management practices that support consistent coaching and fair, data-driven evaluation.
• Participate in team meetings and listen to the voice of the frontline and the member to understand what is driving call volume and complexity, and educate teams on process changes and expectations.

Strategic Initiatives

• Lead or sponsor major initiatives, including new client and program launches, transitions, and operating-model changes, to ensure Customer Care readiness, scalability, and a positive frontline experience.
• Represent Customer Care with executive leadership, clients, and cross-functional partners; take on other projects and responsibilities in support of Customer Care and company goals.

 

Required Qualifications

• Bachelor’s degree in business, healthcare administration, or a related field, or equivalent combination of education and experience.
• 10+ years of experience in a call center or customer care environment, including 7+ years in a leadership role managing managers or multiple teams.
• Demonstrated success improving operational performance, including service levels, quality, efficiency, and member experience, through data-driven process improvement.
• Experience partnering with Quality, Training, Compliance, and Policy functions to drive requirements into operations.
• Experience developing and coaching leaders and building knowledge management capability.
• Strong analytical skills with the ability to turn operational data into insights and executive-ready recommendations.
• Exceptional leadership, interpersonal, problem-solving, verbal and written communication, and conflict resolution skills.
• Proficient with Microsoft 365 products such as Outlook, Word, Excel, and PowerPoint.
• Knowledge of management principles and familiarity with Judi Health products, services, and operational workflows.
• Highest personal integrity.

Preferred Qualifications / Profile

• Pharmacy operations or health insurance operations background.
• Experience with process improvement, quality management, and project management methodologies (for example, Lean, Six Sigma, or PMP).
• Experience with workforce management, forecasting, and capacity planning.
• Proficiency with Salesforce CRM and Salesforce Knowledge, phone systems, and Member Portal.
• Familiarity with HIPAA and healthcare regulatory requirements as they apply to customer care operations.
• Bilingual in Spanish.
• Excellent ability to collaborate and build strong working relationships across the business.
• Member-oriented mindset with the ability to turn a dissatisfied customer into a highly satisfied customer.
• Ability to manage multiple priorities and projects while meeting deadlines.

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. 

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.