MANAGER - CUSTOMER SERVICE

Transformation is the opportunity

Blue Shield of California is the third largest health plan in California, with about $7.5 billion in revenue. Our mission is to ensure Californian's access to high-quality health care at a reasonable price.

Join Blue Shield of California and grow your career with a leader that’s stirring up a change.


Manage the operational performance of the vendor providing call center services for providers. The performance metrics include call center metrics (ASA, Service Level, AHT), Quality (rep perception, first call resolution, MTM Inquiry Accuracy audit performance, Routine Inquiry Accuracy performance, end to end call quality performance – greeting to closing), inventory management of provider cases (aging, cycle time). The vendor has over 120 reps handling over 76,000 calls per month. The vendor operates the call center in the Philippines. The annual operating budget is $2.1 million.

Manage 3 Operation Specialists who provides technical SME (Subject Matter Expert) support to the vendor.

Manage the Quality program at the vendor to ensure the auditors at the vendor are certified per Blue Shield requirements and perform audits to the same Blue Shield internal performance specifications.

Manage the Training program at the vendor to ensure trainers are certified per Blue Shield specifications and the reps at the vendor are trained with Blue Shield designed curriculum and pass training tests and post-training on-the-job tests in order to perform on the Blue Shield account.

Travel 3 times per year to the Philippines. Conduct skip level focus groups with agents, supervisors, trainers and QA analysts to get feedback on successes and opportunities for Blue Shield. Display attitude that Blue Shield cares about them, their performance, their success (which is our success) and Blue Shield supports the vendor.

Manage the vendor to meet Blue Shield performance metrics, review/approve invoices, manage the budget, resolve operational and IT issues, manage contractual SLA’s, provide specific input for contract negotiations, identify and drive continuous process and cost improvements, identify and drive system improvements/enhancements, engage and obtain the mindshare, passion and commitment of the vendor supervisors and customer service agents, learn the cultural differences of the Philippines and manage the associated cultural behaviors that impact how the vendor agents interact with callers.

Establishes operational objectives for department or functional area and participates with other managers to establish group objectives.

Responsible for team, department or functional area results in terms of planning, cost and methods.

Participates in the development and implementation of the annual budget.



Ensures work flow procedures and guidelines are clearly documented and communicated.

Interprets or may initiate changes in guidelines, policies, and procedures.

May lead special projects/committees/task forces.

Has full understanding of applicable legislation/regulations and ensures departmental compliance

BA degree and five years related leadership experience and/or training, or equivalent combination of education and experience.

Excellent human relations and verbal/written communication skills.

Knowledge of on-line systems and flow of information in a high volume production environment.

Knowledge of health care operations and broad understanding of the industry.

Directs and controls the activities of one or more smaller/less complex department(s) or functional area(s) through subordinate supervisors/team leads.

Has full management responsibility for staff (i.e. salary actions, promotions, performance reviews, and disciplinary matters) in accordance with the organization’s policies and applicable laws.

Monitors on-going performance and communicates expectations and results.

Provides developmental and training opportunities for team members.

Identifies staffing needs and objectives.

Plan and execute tactical action/project plans that drive results that meet the department objectives and create a great customer experience.

Exhibit excellent problem solving skills – clearly define the business problem with descriptions, facts and data, measure the problem, analyze the data, identify the root cause of the problem. Design, evaluate and select the solution to improve the problem.

Implement, manage the business processes that make it easy for the reps to execute, are efficient and are designed to deliver quality. This requires interfacing with the vendor, the process team, the quality team, the training team and other member/provider groups in BSC.

Create the business partnership with the vendor that creates a highly motivated, trained and passionate customer service rep team that delivers a high quality experience to the caller.

Blue Shield of California is an Equal Opportunity Employer.


Our comprehensive benefits begin on your first day with medical, dental and vision coverage; 20 days PTO annually; 9 paid holidays; matching 401(k); and company pension.

Blue Shield of California is an Equal Opportunity Employer.

An Independent Member of the Blue Shield Association.

Blue Shield of California

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