Verda Healthcare, Inc. is a Medicare Advantage Prescriptions Drug Plan (MAPD) organization committed to the idea that healthcare should be easily and equitably accessed by all, currently available in Texas and Arizona. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Director, Call Center to join our growing company with many internal opportunities.
Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare health plan is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.
Align your career goals with Verda Healthcare, Inc. and we will support you all the way.
Position Overview
The Director, Call Center is a senior leadership role responsible for the strategic direction, operational excellence, and regulatory compliance of Verda Healthcare’s member call center operations. This position oversees all aspects of call center performance to ensure a high-quality, compliant, and member-centered experience across Verda’s Medicare Advantage Prescription Drug (MAPD) plans. The Director partners closely with executive leadership, Compliance, Technology, and Operations teams to drive service excellence, optimize performance through data and analytics, and support Verda’s mission to deliver equitable, accessible healthcare to underserved communities in Texas, Arizona, and future expansion markets.
This position reports to the Chief Operating Officer.
Responsibilities:
Strategic & Operational Leadership
Education
Job Type: Full-time employment
Location: Huntington Beach, CA
Compensation Range:
$125,000 – $150,000 annually
Actual compensation offered will be determined based on experience, qualifications, skills, internal equity (if available), and geographic location. This position may also be eligible for performance-based incentive compensation and benefits. Benefits:
Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.
*Other duties may be assigned in support of departmental goals.
Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare health plan is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.
Align your career goals with Verda Healthcare, Inc. and we will support you all the way.
Position Overview
The Director, Call Center is a senior leadership role responsible for the strategic direction, operational excellence, and regulatory compliance of Verda Healthcare’s member call center operations. This position oversees all aspects of call center performance to ensure a high-quality, compliant, and member-centered experience across Verda’s Medicare Advantage Prescription Drug (MAPD) plans. The Director partners closely with executive leadership, Compliance, Technology, and Operations teams to drive service excellence, optimize performance through data and analytics, and support Verda’s mission to deliver equitable, accessible healthcare to underserved communities in Texas, Arizona, and future expansion markets.
This position reports to the Chief Operating Officer.
Responsibilities:
Strategic & Operational Leadership
- Provide enterprise-level leadership for the Call Center operations, ensuring alignment with organizational strategy, CMS requirements, and member satisfaction goals.
- Establish and monitor KPIs, service level agreements (SLAs), productivity benchmarks, and quality standards.
- Lead continuous improvement initiatives to enhance workflows, efficiency, and member outcomes.
- Analyze trends, performance metrics, complaints, and grievances to drive data-informed decision-making.
- Directly manage managers and/or senior leaders within the Member call center.
- Foster a high-performance, member-centric culture focused on accountability, engagement, and development.
- Oversee workforce planning, scheduling, skill-based routing, lunch and break coverage, and resource optimization.
- Develop leadership succession plans, training programs, and cross-training strategies.
- Ensure compliance with CMS, HIPAA, state regulatory requirements, and internal policies.
- Oversee call monitoring, quality assurance programs, corrective action plans, and audit readiness.
- Ensure all phone systems, IVR, ACD, digital tools, and member web links function optimally and meet regulatory standards.
- Partner with Compliance and Legal teams to mitigate operational and regulatory risk.
- Oversee call center systems, reporting, dashboards, and analytics to improve performance and the member experience.
- Prepare and present executive-level reports on performance, trends, risks, and improvement initiatives.
- Leverage technology and automation to improve service delivery and scalability.
- Manage relationships with external vendors to ensure contractual SLAs and regulatory obligations are met.
- Collaborate with internal departments to ensure consistent, accurate, and timely member communications.
- Serve as a subject matter expert and escalation point for complex member issues.
- Serve as a role model demonstrating integrity, professionalism, and member advocacy.
- Encourage innovation, accountability, and continuous feedback across teams.
- Perform other duties as assigned in support of departmental and organizational objectives.
Education
- Bachelor’s Degree required (Healthcare Administration, Business, Public Health, or related field preferred).
- Minimum 7–10 years of progressive experience in managed care, health plan member services, or call center operations.
- Minimum 5 years of leadership experience at the manager or senior manager level; director-level experience strongly preferred.
- Demonstrated experience with CMS regulations, Medicare Advantage requirements, grievances/appeals, complaints, and Star Ratings.
- Strong background in call center operations, reporting, analytics, and performance optimization.
- In-depth knowledge of medical terminology and health plan operations.
- Proven ability to lead large, diverse teams and manage through change.
- Advanced analytical, strategic thinking, and problem-solving skills.
- Strong executive-level written and verbal communication skills.
- Proficiency with Microsoft Office (Word, Excel, Outlook, Teams) and call center/CRM systems.
- Ability to present complex information clearly to senior leadership and external stakeholders.
- Integrity and Trust
- Member/Customer Focus
- Strategic Leadership
- Functional & Technical Expertise
- Written and Oral Communication
- Critical and Analytical Thinking
Job Type: Full-time employment
Location: Huntington Beach, CA
Compensation Range:
$125,000 – $150,000 annually
Actual compensation offered will be determined based on experience, qualifications, skills, internal equity (if available), and geographic location. This position may also be eligible for performance-based incentive compensation and benefits. Benefits:
- 401(k)
- Paid time off (vacation, holiday, sick leave)
- Health insurance
- Dental Insurance
- Vision insurance
- Life insurance
- Full-time onsite (100% in-office)
- Hours of operations: 9am – 6pm
- Standard business hours Monday to Friday/weekends as needed
- Occasional travel may be required for meetings and training sessions.
- Reliably commute or planning to relocate before starting work (Required)
Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.
*Other duties may be assigned in support of departmental goals.
