Dir, Contact Center Operations (Finance)

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, *IL, KS, LA, MD, *MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

The Director of Contact Center Operations will oversee and manage the operations, performance, and strategic direction of TRICARE and VA Community Care Network (CCN) programs within the contact center, ensuring the delivery of high-quality care for Military and Veteran populations. This role is responsible for maintaining effective relationships with the VA Medical Centers (VAMCs), the Military Treatment Facilities (MTFs), the Government administrative leadership for both programs, TriWest Network Providers, Beneficiaries, Care Givers, and their families. Strategic imperatives include managing compliance with all regulatory requirements and achieving operational and programmatic goals within the TRICARE and VA Community Care Contracts.

Focuses on driving efficiencies and innovation that support meeting and exceeding specific contractual contract metrics and standards. Responsible for the collaboration with contractor partners and TriWest departments to optimize resources, processes, and technology. Supports and makes recommendations regarding the execution of TriWest's CRM, the infusion of artificial intelligence into departmental systems, and combines traditional healthcare call center concepts of customer, provider and claims management with governmental compliance to create synergies that support TriWest and all internal departments in meeting customer service performance guarantees per the CCN and TRICARE contracts. Ensures appropriate call center certification is achieved and maintained specific to cost-per-call, production, quality, and employee satisfaction metrics.

Education & Experience

Required:

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or related field
• Must be a U.S. Citizen
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DOD) background adjudication
• 5+ years of progressively, responsible, people management experience to include leadership staff
• 5+ years' experience in a large-scale contact center environment

Preferred:

• Previous proven leadership in a TRICARE or Community Care Network (CCN) Contact Center
• Proven successful team performance delivery of SLAs and contract compliance in a TRICARE or CCN
• Contact Center to include the management of eligibility, enrollment, claims, provider, and government partners
• Proven successful experience in executing and managing vendor relationships to achieve contract standards and SLAs within a performance based call center
• Master's Degree in Business Administration, Healthcare Administration or related field
• Veteran or Military Spouse or military affiliated

Key Responsibilities

1. Program Leadership:
• Lead the TRICARE and VA Community Care Network program initiatives, ensuring all objectives align with the mission of providing exceptional care to veterans, active military personnel, their caregivers and families, and government customers.
• Develop and implement strategic plans for the continued success and growth of both programs.
• Serve as the primary point of contact for senior leadership, government agencies (DoD, VA), and contracted healthcare providers. 2. Operations Management:
• Oversee the day-to-day operations of the TRICARE and VA Community Care Network programs, including the support of claims processing, enrollment activities, referral and authorization processing, and quality control.
• Partner with the Director of Contact Center Performance to achieve performance standards and drive quality and customer satisfaction.
• Implement and monitor processes to ensure efficient administration and management of services within the program.
• Manage program timelines, reduce operational costs, and ensure effective resource allocation through maintaining hiring to support regular operations and contingencies.

3. Compliance & Regulatory Oversight:
• Ensure compliance with all applicable federal regulations, including those specific to TRICARE and VA CCN requirements.
• Monitor and enforce quality assurance standards in specific to the contractual guidelines of the Department of Defense and Department of Veterans Affairs regulations.
• Oversee audits, inspections, and reviews of program performance and resolve any discrepancies or issues identified. 4. Stakeholder Management:
• Collaborate with key stakeholders, including VA leadership, DoD representatives, healthcare providers, and other third-party contracted partners, to ensure alignment of goals and consistent delivery of services.
• Maintain positive relationships with both the Military and Veteran communities, acting as a liaison to resolve issues and concerns with urgency. 5. Data & Reporting:
• Review and analyze performance metrics, trends, and program outcomes to ensure that both TRICARE and VA CCN programs meet or exceed service expectations.
• Produce and deliver detailed reports to leadership and stakeholders, highlighting areas of success, areas for improvement, and plans for optimization.

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6. Call Center Certification and Cost Management:
• Support the cost center budget, ensuring adherence to financial goals and resource allocation.
• Conduct cost-benefit analyses and identify opportunities for program efficiencies without compromising care quality. 7. Staff Leadership & Development:
• Manage and mentor a team of managers responsible for the execution of program tasks, ensuring high levels of motivation, productivity, and morale.
• Develops succession plans to include the development of staff at all levels of the Contact Center Operational team. Sets targets to increase Contact Center productivity and quality through the development of organizational talent. Cascades corporate goals and holds Managers accountable for the realization of results through formal employee development plans.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Ability to understand impact of computer functionality on work processes and look for efficiencies.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Empathy / Customer Service: Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources.

Information Management: Solid understanding of compliance and regulatory issues related to military and veterans' healthcare.

Leadership: Successfully manage different styles of employees; Provide clear direction and effective coaching.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.

Problem Solving / Analysis: Detail-oriented with a strategic mindset, capable of driving continuous improvement.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Knowledge of contact center information systems, claims systems, medical management systems and CCN processes, procedures and contract requirements.

Working Conditions

Working Conditions:

• Availability to work non-regular hours as required
• Onsite: Works within a standard office environment
• Remote: Private and secure workspace and workstation
• Ability to travel up to 25% of scheduled hours when requested

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Generous paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Illinois, Minnesota, Washington D.C. and Washington State residents: $164,000-$210,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.