Director, Customer Care
DIRECTOR, CUSTOMER CARE
ONSITE
EMPLOYMENT TYPE: Full-Time, Exempt
POSITION PURPOSE
The Director of Customer Care is responsible for leading the strategy, development, and execution of all member-facing service, engagement, and communication functions at Umpqua Health. This role oversees the end-to-end member experience across inbound and outbound operations, including the Customer Care Call Center, Member Engagement operations, proactive outreach initiatives, and the full lifecycle of member communications from enrollment through disenrollment. The Director ensures Oregon Health Plan (OHP) members are informed of their rights, actively engaged as partners in their care, and supported through clear, culturally responsive, accessible, and compliant communication across all channels. Serving as the organizational champion for the member voice, this position is accountable for ensuring compliance with CCO contractual requirements while translating regulatory expectations into measurable service standards, scalable operational processes, and a culture grounded in equity, member advocacy, and service excellence.
ESSENTIAL JOB RESPONSIBILITIES
Customer Care & Call Center Operations
Lead the strategy, operations, staffing, training, and performance of the Customer Care Call Center, including inbound and outbound member services.
Ensure call center operations meet contractual service level standards, quality metrics, and accessibility requirements.
Oversee multilingual support services, interpreter access, and accommodations for members with hearing or speech impairments.
Manage call center technology platforms, quality assurance processes, call monitoring, scripting, and staff coaching initiatives.
Develop workforce and contingency staffing plans to support operational and contractual performance standards.
Member Engagement & Communications
Design and implement member engagement and outreach strategies across phone, mail, email, SMS, digital, and in-person channels.
Ensure member communications are culturally responsive, accessible, compliant, and written in plain language.
Oversee member outreach documentation and communication workflows within the Health Information System.
Partners with internal departments to align member engagement activities with care coordination, quality, and population health initiatives.
Support outreach and engagement efforts for vulnerable and high-risk member populations, including Medicare-eligible and dual-eligible members.
Member Rights, Compliance & Regulatory Oversight
Ensure compliance with Medicaid member rights, nondiscrimination requirements, language access standards, and member communication regulations.
Oversee the distribution and maintenance of required member notices, rights information, and accessibility resources.
Ensure staff are trained in member rights, grievances and appeals, interpreter services, fraud and abuse reporting, and enrollment/disenrollment processes.
Collaborate with Compliance, Privacy, and Regulatory teams to maintain compliant member-facing operations and materials.
Member Materials & Lifecycle Support
Oversee the development, review, approval, and distribution of member-facing materials, including handbooks, directories, notices, welcome materials, and educational content.
Ensure all materials meet readability, accessibility, translation, and regulatory requirements.
Support member enrollment, disenrollment, transitions of care, and onboarding communications.
Partner with internal teams to support enrollment reconciliation and member data accuracy processes.
Grievance & Appeals Support
Partner with Utilization Management and Compliance teams to support grievance and appeal processes.
Ensure members receive appropriate assistance with grievances, appeals, interpreter services, and access to support resources.
Support regulatory audits, investigations, and documentation requests related to member complaints and appeals.
Health Equity & Community Engagement
Promote culturally and linguistically appropriate services (CLAS) standards across all member touchpoints.
Use member demographic and engagement data to identify disparities and improve outreach strategies.
Build collaborative relationships with community organizations, Tribal partners, and culturally specific organizations to strengthen member engagement efforts.
Support member education regarding available community resources and care support services.
Cross-Functional Leadership & Performance Management
Partner with Quality, Care Coordination, Pharmacy, Provider Network, IT, Compliance, and other operational teams to support organizational goals and member experience initiatives.
Develop and monitor departmental performance metrics, dashboards, and reporting related to member engagement, satisfaction, accessibility, and operational performance.
Lead department participation in audits, readiness reviews, and compliance activities.
Oversee departmental policies, procedures, workflows, and continuous improvement initiatives.
People Leadership
Lead hiring, onboarding, training, coaching, performance management, and professional development for Customer Care staff.
Foster a high-performing, member-centered culture focused on accountability, service excellence, collaboration, and continuous improvement.
Provide leadership and support in a fast-paced, evolving environment while maintaining effective communication across teams and stakeholders.
Performs other duties and responsibilities as assigned to support the department and organizational operations.
CHALLENGES
- Working with a variety of personalities, maintaining a consistent and fair communication style.
- Satisfying the needs of a fast-paced and challenging company.
MINIMUM QUALIFICATIONS
Bachelor’s degree in health administration, public health, marketing, communications, social work, or a related field.
7+ years of progressive member services, member engagement, or member experience work in a healthcare or health plan setting; Medicaid/CCO experience strongly preferred.
5+ years of direct accountability for a multi-channel member-facing Call Center or Member Services operation, including responsibility for service-level performance, workforce management, quality monitoring, and vendor/technology platforms.
5+ years of people leadership experience, including managing managers or cross-functional teams.
Demonstrated experience operating a Grievance and Appeal System or equivalent member complaint/resolution function in a regulated managed care environment.
Proven ability to develop, execute, and measure multi-channel member engagement and outreach strategies in a highly regulated environment.
Strong analytical, communication, and project management skills with the ability to present to senior leadership, regulators, community partners, and Tribal leadership.
Valid driver’s license, reliable transportation, and ability to maintain automobile insurance coverage meeting organizational requirements.
No suspension, exclusion, or debarment from participation in federal healthcare programs (e.g., Medicare/Medicaid).
Proficient computer skills, including Microsoft Office Suite; familiarity with call center telephony systems, CRM/member engagement platforms, and reporting or business intelligence tools.
Master’s degree preferred.
7+ years of progressive member services, member engagement, or member experience work in a healthcare or health plan setting; Medicaid/CCO experience strongly preferred.
Demonstrated working knowledge of Oregon CCO contract requirements.
Direct experience developing and maintaining member-facing materials under OHA review, including Member Handbooks, Provider Directories, Welcome Packets, and member rights education materials.
Familiarity with OHA material submission and review processes, CLAS standards, REAL+D demographic data collection, and interpreter service requirements.
Experience with engagement platforms and digital outreach tools in a Medicaid setting.
Experience partnering with Federally Recognized Tribes, Tribal Organizations, Traditional Health Workers, and community-based organizations.
Experience considering the impacts of work across diverse communities and populations in operational or technical analysis.
Experience working within diverse teams and across varying communication styles.
Bilingual or biliterate skills (English/Spanish or other prevalent non-English language) preferred.
SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band: $113,055- $132,840
BENEFITS
- Salary is dependent on skills, experience, and education
- Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
- Medical, dental, and vision insurance
- 401(k) with company match (fully vested immediately)
- Company-sponsored life insurance and additional benefits
- Fitness reimbursement program
- Tuition reimbursement and more
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
