Director, Operations (Government Markets)

Your Role 

The Government Markets Customer Experience team supports member interactions from our Government Markets members. The Director, Government Markets Customer Service will report to the Sr. Director, Government Markets Customer Experience. Through strategic leadership and oversight of frontline agents, supervisors, and managers, the Director of Government Markets Customer Experience ensures every member interaction reflects Blue Shield's commitment to delivering service worthy of our family and friends. By fostering a culture of accountability, compassion, and continuous improvement, this leader drives exceptional service experiences that strengthen member trust, improve outcomes, and advance Blue Shield's mission. Their leadership enables teams to consistently deliver personalized, high-quality support that makes healthcare easier to navigate and more accessible for the members we serve. 

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Responsibilities

Your Work 

In this role, you will: 

• Provide strategic and operational leadership for inbound contact center operations supporting Government Markets lines of business, including Individual & Family Plans (IFP), Medi-Cal, Medicare, and Medicare Supplement 

• Lead and develop a high-performing organization of frontline agents, supervisors, and managers to deliver exceptional member experiences aligned with Blue Shield's mission and service standards 

• Drive performance against key operational metrics, including service level, quality, issue resolution, member satisfaction, Net Promoter Score (NPS), compliance, and cost efficiency

• Ensure consistent delivery of accurate, compassionate, and timely service for members navigating healthcare benefits, coverage, claims, provider access, and care-related inquiries

• Partner cross-functionally with Operations, Clinical, Product, Provider Services, Appeals & Grievances, Compliance, and Technology teams to resolve member issues and improve end-to-end experiences

• Lead customer experience Improvement initiatives in partnership with cross functional teams, leveraging technology, process optimization, automation, and self-service capabilities to improve member outcomes and operational efficiency

• Ensure adherence to regulatory requirements and contractual obligations associated with Medicare, Medi-Cal, and other Government Markets programs

• Utilize data, analytics, and member feedback to identify trends, address root causes, and implement sustainable improvements that enhance both member and employee experiences

• Serve as a trusted leader and advocate for members, championing Blue Shield's commitment to provide service worthy of our family and friends through every interaction and touchpoint

Qualifications

Your Knowledge and Experience

 

• Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree

• Master’s degree preferred

• Requires at least 10 years of prior relevant experience, including at least 6 years of management experience

• Requires robust knowledge of health insurance, knowledge of Government Health Plan programs required (Medicare, Medi-Cal, Covered CA)

• Requires extensive leadership experience and proven track record of driving sustained performance in call center operations

• Bilingual (Spanish) a plus

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. 

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. 

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values: 

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short. 
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals. 

Our Workplace Model 

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.

• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.

• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail. 

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.