COMPANY OVERVIEWAt Harbor Health, we're transforming healthcare in Austin through collaboration and innovation as a payvider—integrating comprehensive care delivery with a modern health insurance payment model. We're seeking passionate individuals to help us create a member-centered experience across our health plan, medical clinics, and ACO operations. If you're ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!POSITION OVERVIEWThe Director, Call Center Operations ensures operational excellence, regulatory compliance, and member/provider satisfaction across Harbor Health's integrated payvider model. This role oversees call center operations for both health plan and clinical functions, managing SLA achievement, TPA partnerships, budgets, and quality assurance while ensuring compliance with TDI, CMS, and government regulations.POSITION DUTIES & RESPONSIBILITIESOversee call center operations for member services, claims, prior authorizations, appeals, and provider supportAchieve monthly SLAs and implement corrective action plans for performance gapsManage telephony systems, IVR routing, call queues, and optimize call center software functionalityHire, develop, and coach team members for performance excellence and career growthEnsure compliance with TDI, CMS, and government regulations; manage risks per compliance policiesCreate and maintain process flows, SOPs, and job aids for operational consistencyCollaborate with vendors on system configurations and integrationsManage escalated calls and establish seamless handoffs with supporting teamsPartner with business leaders to design metrics and dashboards with high analytical rigorIdentify opportunities to improve efficiency, reduce costs, and enhance member/provider experiencesManage operational budgets and resource allocationDESIRED PROFESSIONAL SKILLS & EXPERIENCERequired:Bachelor's degree or 8+ years healthcare operations experience6+ years managing payer health plan call centers covering claims, member services, appeals, and provider supportDeep understanding of benefits, prior authorizations, claims processing, and appeals workflowsKnowledge of call center functionality including IVR setup and queue managementExperience developing operational SOPs and business requirement documentsProven ability to coach teams and manage multiple priorities independentlyStrong written and verbal communication skillsPreferred:Familiarity with TDI and CMS rules and regulationsStartup phase health plan experienceBackground building call center teams from the ground upAdvanced Excel and PowerPoint skillsHigh integrity with commitment to confidentiality and compliance standardsWHAT WE OFFEROpportunity to build and scale call center operations for a growing payvider startupCollaborative and dynamic work environmentTeam passionate about transforming healthcare delivery in AustinCompetitive salary and benefits packageProfessional development and growth opportunitiesTransparent and unique startup cultureHarbor Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive environment for all clinicians and teammates and actively encourage applications from people of all backgrounds.
