Director, Customer Experience

Summary

Join Clover Health as the Director of Customer Experience and lead the execution of the customer engagement strategy, ensuring exceptional experiences for Medicare Advantage members and providers. Partner with the VP of Customer Experience to cultivate a customer-centric culture, oversee service center operations (in-house and third-party), and leverage AI to enhance customer experience initiatives. You will be responsible for establishing a concierge call center for high-engagement members, analyzing data to optimize call center operations, and creating a feedback loop to business leadership. Success in this role involves improving member and provider satisfaction, optimizing service center operations, increasing customer self-service, and enhancing call quality. The ideal candidate will have extensive experience in call center management, Medicare Advantage, and team leadership, along with a strong understanding of AI and data analysis.

Requirements

• You have 7+ years of call center experience (required)
• You have 7+ years of experience working in a Medicare Advantage environment (required)
• You have 7+ years of experience managing a team (required)
• You have a Bachelor’s degree in business, health administration, finance, or related field required; advanced degree (MBA, MHA, MPH) a plus

Responsibilities

• Partner with the VP of Cx to drive a Cx-centered culture
• Provide input to help define a winning Cx strategy, focusing on Medicare Advantage members and providers
• Lead the execution of the customer engagement strategy for the Medicare Advantage business
• Stand up and manage a concierge call center for VIP and at-risk members
• Provide requirements into the overall CRM roadmap
• Identify and implement AI-driven solutions to enhance customer experience, such as leveraging AI for call center agents, customer self-service solutions, call quality monitoring, and sentiment analysis
• Leverage AI to collect and analyze the voice of the customer, as reflected throughout the Service Center interactions
• Provide input and requirements into the Cx Customer Data Platform and Digital Journey, including the integration of AI capabilities
• Establish an integrated and holistic feedback loop of the Voice of the Customer to the business
• Be accountable for understanding the direction of the company and its associated service needs
• Work cross-functionally with peers in Sales, Marketing, Provider Engagement, Clinical Operations, Claims, Enrollment, etc. to coordinate and grow together, and cascade down to your team for a clear direction
• Oversee and optimize third-party call centers, both stateside and offshore, handling member and provider services
• Oversee offline case inventory, such as secure messaging, email, case escalations, voicemail, and chat, for both members and providers
• Oversee a third-party outbound team focused on member retention and growth, including demand and capacity planning, outbound lead generation, reporting, data loading, training, scripting, and performance
• Oversee an internal Quality Assurance team, focused on trend identification, process improvement, and strategic alignment across the enterprise
• Own the development and maintenance of all Standard Operating Procedures relating to member, provider, and broker experience, including training materials and DLP repositories
• Oversee vendor relationships for multiple supplemental benefit vendors, including regular touchpoints, reporting, call calibration sessions, performance management, invoice validation, RFP participation, and overall strategy
• Oversee and be accountable for the performance of assigned vendors, including but not limited to Service Levels, ASA, NPS, FCR, Handle Time, and Post Call Surveys
• Oversee and optimize workforce scheduling
• Work with Clover's Compliance Team to ensure regulatory compliance in our communications, research and respond to CTMs, and update monthly delegatory reporting
• Work with IT operations and workforce management to develop, maintain, and improve IVR call flows, system enhancements, and data needs
• Own the onboarding and system access acquisition for all Call Center vendor and internal employees
• Develop, measure and track Cx Service Center goals and metrics and ensure they are being met
• Manage communication activities, performance expectations and goals, evaluate processes and outcomes, and implement improvements to support quality and efficiency

Preferred Qualifications

• You have experience managing a third-party offshore call center (preferred)
• You have extensive knowledge of back-office health plan functions (Claims, Enrollment, Provider Services)
• You have a strong understanding of AI technologies and their application in customer experience, particularly within a call center environment
• You have advanced proficiency in data analysis and spreadsheet software (e.g., Microsoft Excel, Google Sheets) with experience handling large datasets

Benefits

• Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities
• Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions
• We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage
• Your health matters to us, and we invest in ensuring you have access to quality healthcare
• We understand the importance of mental health in fostering productivity and maintaining work-life balance
• To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy
• Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location
• Developing internal talent is a priority for Clover
• We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews
• Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
• Reimbursement for office setup expenses
• Monthly cell phone & internet stipend
• Remote-first culture, enabling collaboration with global teams
• Paid parental leave for all new parents