Director Operational Oversight

GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.

GEHA has one mission: To empower federal workers to be healthy and well.

Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.

Duties and Responsibilities

• Develop and refine core expertise in Customer Care and claims administrative and offline support functions to align with industry standards and apply best practices to identified areas of improvement.

• Ensures consistency in the delivery and application of training and enhancement standards within Customer Care and claims. Oversee the planning, prioritization and development of programs and initiatives that are consistent with the Department's overall customer strategy, objectives and needs.
• Define and enhance existing digital channel support policies and objectives. Actively manage interactions to continuously delivery efficient resolution to customer issues.

• Accountable for oversight and timely review of Customer Care and claims reference documentation and materials for all departmental functions.
• Consistently delivers results against established Customer Care and claims performance metrics including Accuracy and First Call Resolution, inventory, aging, and quality. Ensures that standards are following OPM requirements as well as internal protocols and goals. Implements mitigation measures as needed to meet targets.
• Oversee quality functions as related to Customer Care and claims Audits.

• Collaboration with Operations leadership at UMR on identified opportunities for training, coaching and development of new and existing employees.

• Establish and maintain high performing teams who embraces a culture focused on continuous improvement, bridging skills and competencies to minimize knowledge gaps.
• Ensures an ethical and inclusive environment in accordance with company policies and health care industry regulations and standards.

Knowledge, Skills, and Abilities

• Bachelor's degree in business, Operations, and/or related field of study.

• Requires ten years of progressive experience in Claims, Customer Care, and/or Customer Service operations with at least 5 years of management experience.

• Proven ability to partner and collaborate across the enterprise in leading impactful change in Customer Care and claims technology, processes, and operational initiatives.

• Requires demonstrated experience in strategy development and initiative deployment based on the mid to long term vision, translating strategies into actions while inspiring the team to embrace change and deliver operational results.

• Excellent written and verbal communication skills with proven success collaborating with all levels of employees and customers.

• Advanced leadership skills, combined with the ability and willingness to be an individual contributor as well.

• High digital acumen; understanding of technology (e.g., SharePoint, NICE, social media) and best practices for how to deliver on outstanding Customer Service.

• Strong analytical skills with an in-depth understanding of contact center and claims support and operations.

• Proven ability to provide direction and to support the execution of high-level customer service and claims related strategies.

• Incumbent is required to obtain knowledge of GEHA's Affirmative Action policy and make decisions regarding employment, promotion, and termination of employees that comply with its principles.

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
• Latency (ping) response time lower than 80 ms
• Hotspots, satellite and wireless internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges
• Incentive plan
• Health/Vision/Dental benefits effective day one
• 401(k) retirement plan: company match - dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
• Robust employee well-being program
• Paid Time Off
• Personal Community Enrichment Time
• Company-provided Basic Life and AD&D
• Company-provided Short-Term & Long-Term Disability
• Tuition Assistance Program

Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.

GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.