Harbor Health

Compensation

Full Description

COMPANY OVERVIEW At 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 OVERVIEW The 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 & RESPONSIBILITIES Oversee call center operations for member services, claims, prior authorizations, appeals, and provider support Achieve monthly SLAs and implement corrective action plans for performance gaps Manage telephony systems, IVR routing, call queues, and optimize call center software functionality Hire, develop, and coach team members for performance excellence and career growth Ensure compliance with TDI, CMS, and government regulations; manage risks per compliance policies Create and maintain process flows, SOPs, and job aids for operational consistency Collaborate with vendors on system configurations and integrations Manage escalated calls and establish seamless handoffs with supporting teams Partner with business leaders to design metrics and dashboards with high analytical rigor Identify opportunities to improve efficiency, reduce costs, and enhance member/provider experiences Manage operational budgets and resource allocation DESIRED PROFESSIONAL SKILLS & EXPERIENCE Required: Bachelor's degree or 8+ years healthcare operations experience 6+ years managing payer health plan call centers covering claims, member services, appeals, and provider support Deep understanding of benefits, prior authorizations, claims processing, and appeals workflows Knowledge of call center functionality including IVR setup and queue management Experience developing operational SOPs and business requirement documents Proven ability to coach teams and manage multiple priorities independently Strong written and verbal communication skills Preferred: Familiarity with TDI and CMS rules and regulations Startup phase health plan experience Background building call center teams from the ground up Advanced Excel and PowerPoint skills High integrity with commitment to confidentiality and compliance standards WHAT WE OFFER Opportunity to build and scale call center operations for a growing payvider startup Collaborative and dynamic work environment Team passionate about transforming healthcare delivery in Austin Competitive salary and benefits package Professional development and growth opportunities Transparent and unique startup culture Harbor 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.