Position Overview
FusionCX is seeking an experienced and results-driven Healthcare Program Manager to oversee the day-to-day operations of a healthcare call center program. This position is responsible for ensuring operational excellence, delivering a high-quality member experience, developing leadership teams, and achieving client and program performance goals.
The Healthcare Program Manager will work closely with Operations, Quality, Training, Workforce Management, Human Resources, and client leadership to ensure the program meets established standards for service, quality, productivity, compliance, and customer satisfaction.
The ideal candidate is a strong people leader with healthcare call center experience, excellent communication skills, and the ability to manage multiple priorities in a fast-paced environment.
Key Responsibilities
Program & Operations Management
- Oversee the daily operations of the healthcare customer service program.
- Ensure the program consistently meets or exceeds client and internal performance expectations.
- Monitor operational performance, including service levels, productivity, attendance, quality, customer satisfaction, and other key performance indicators.
- Identify operational challenges and develop action plans to improve performance.
- Ensure staffing levels and schedules support program requirements.
- Partner with Workforce Management to address staffing, scheduling, and service-level needs.
- Maintain accountability for program goals and performance results.
Leadership & Team Development
- Lead, coach, and develop Operations Managers, Supervisors, and other program leadership staff.
- Establish clear performance expectations and hold leadership teams accountable for results.
- Conduct regular leadership meetings and performance reviews.
- Identify opportunities for employee development and succession planning.
- Promote a positive, customer-focused culture throughout the program.
- Assist leadership with employee engagement, retention, and recognition initiatives.
Healthcare Customer Experience
- Ensure members receive professional, accurate, compassionate, and timely service.
- Monitor trends in member concerns, escalations, complaints, and service issues.
- Partner with Quality and Training teams to address performance gaps.
- Ensure agents understand healthcare-related processes, benefits, eligibility, claims, referrals, and other program-specific requirements.
- Support escalation management for complex member or client issues.
Quality & Compliance
- Ensure operations follow all applicable healthcare program requirements, company policies, and client procedures.
- Partner with Quality and Compliance teams to identify trends and implement corrective actions.
- Ensure appropriate documentation and data handling practices are followed.
- Monitor compliance-related performance and address gaps promptly.
- Support audits, client reviews, and compliance initiatives as needed.
Reporting & Performance Management
- Review daily, weekly, and monthly performance reports.
- Analyze KPIs and identify trends, risks, and opportunities.
- Develop and present performance updates to senior leadership and clients when applicable.
- Create and execute performance improvement plans.
- Track corrective actions through completion and measure the effectiveness of improvements.
- Use data to make informed operational and staffing decisions.
Client Relationship Management
- Serve as a primary operational point of contact for assigned healthcare program stakeholders.
- Maintain strong professional relationships with clients and internal leadership.
- Participate in client meetings, business reviews, and performance discussions.
- Communicate operational challenges, successes, and improvement plans effectively.
- Ensure client expectations are clearly communicated throughout the organization.
Key Performance Indicators
The Healthcare Program Manager may be accountable for performance across areas including:
- Customer Satisfaction (CSAT)
- Quality Scores
- Service Level
- Average Handle Time (AHT)
- First Call Resolution (FCR)
- Attendance and Adherence
- Productivity
- Schedule Adherence
- Attrition/Retention
- Escalation Rates
- Compliance
- Client Satisfaction
- Training Performance
Qualifications
- High school diploma or equivalent required; bachelor's degree preferred.
- 3+ years of call center or customer service leadership experience.
- 2+ years of experience managing healthcare, insurance, Medicare, or member-services operations preferred.
- Previous experience managing Supervisors, Operations Managers, or large customer service teams.
- Strong understanding of call center KPIs and performance management.
- Experience working with multiple systems, workflows, and operational processes.
- Strong analytical and problem-solving skills.
- Excellent written and verbal communication skills.
- Ability to present performance information to leadership and clients.
- Strong organizational and time-management skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Demonstrated ability to coach, motivate, and develop leadership teams.
- Strong understanding of customer service principles and member experience.
Preferred Experience
- Healthcare call center experience
- Medicare or health insurance experience
- Experience supporting members, patients, providers, or brokers
- Experience with regulated healthcare programs
- Experience working with client performance requirements
- Experience with CRM and workforce management systems
- Experience with quality assurance and compliance programs
- Experience managing large-scale inbound and/or outbound call center operations
Schedule
This is a full-time leadership position. The Healthcare Program Manager must be willing to work a schedule that supports program operating hours and may occasionally be required to work evenings, weekends, or additional hours based on business needs.
Pay: From $45,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person