Skip to Main Content

Kaiser Permanente Careers

Customer Service

Making Each Interaction Extraordinary

Functioning as a liaison between our members, employer groups, providers, brokers, and internal customers, our customer service groups are the face and voice of Kaiser Permanente. They play a vital role in explaining our offerings, policies, and procedures as well as meeting the needs of our members across the country.

Director Operations Member Services

Location: San Diego, CA Additional Locations:
Job Number: 750999 Date posted: 11/16/2018
Provide leadership, overall management, strategic direction, and support to the Local Member Services professional staff, across multiple sites. Responsible for Member Services daily operations, initiatives, oversight of case processing, issue resolution, quality of information and service provided by staff to both internal and external customers. Support and represent Kaiser Foundation Health Plan Member Services, and strategize with Regional and Local leadership, facility personnel, and physicians to minimize the financial risk to the organization and ensure contract integrity for our members as well as Kaiser Permanente. Provide performance based consulting to department management and facilities throughout Northern California. Provide service recovery in order to assist in the retention of our members. Drive the mission and business results for Kaiser Permanente while meeting budgetary guidelines to ensure responsible stewardship of our member's dues.

Essential Responsibilities:
  • Provides leadership (responsibility and oversight/management) for member services at the medical center and medical offices for designated facilities, including budgetary, compliance, service and quality oversight.
  • Identifies member and non-member pain points, and works with area leaders to drive continuous service improvements, partnering with these local and regional leaders to reduce complaints and grievances, while increasing member satisfaction, growth and retention.
  • Acts as key liaison with the medical group; develops programs and service improvements in conjunction with key medical group personnel, managers, and physicians, to improve member experience and resolve member issues as quickly and effectively as possible.
  • Handles high risk issues by managing timely communication with medical facilities.
  • Provides ongoing information, reports and recommendations to facility departments and physician chiefs related to data analysis and provision of reports and information related to services and concerns that arise in specific departments.
  • Oversees the daily operations of the member services department, including linkage with auditing, training and analyst work to best meet the needs of staff, members, key stakeholders, and leadership.
  • Identifies member-system conflict in an effort to prevent professional liability, minimize financial penalties to the organization, and retain satisfied members.
  • Hires, supervises, coaches/trains and develops staff who handle sensitive and multi-faceted member issues and requests.
  • Creates a team atmosphere and structure that promotes self-directed work through the development and empowerment of staff.
  • Orients and educates facility departments, physicians and other professional staff regarding health plan products, benefits, regulatory guidelines, resolution of member questions, complaints and grievances.
  • Fosters a service oriented work environment with an emphasis on dedication to serving members, affording respect to individuals, achievement of highest standards of quality, identifying and supporting opportunities for innovation, supporting teamwork and implementing policies and practices that reflect the vision of KP.
  • Basic Qualifications:
  • Minimum eight (8) years of management/leadership experience in a complex healthcare (preferably HMO) or service-oriented organization
  • Minimum three (3) years of experience in customer service improvement and process redesign, with openness to creative and innovative approaches to providing service, including cultural sensitivity, respect and polite communication with patients and all clientele
  • Minimum three (3) years of experience working with accreditation and regulatory agencies and/or preparing information for regulatory audits as requested, (including, but not limited to Department of Health Services (DHS), Department of Managed Healthcare (DMHC), National Committee for Quality Assurance (NCQA), and Center for Medicare/Medicaid Services (CMS)
  • Education
  • Bachelor's degree in Health Care Administration, Business Management, Science or Business or four (4) years of experience in a directly related field.
  • High School Diploma or General Education Development (GED) required.
  • License, Certification, Registration
  • N/A

  • Additional Requirements:
  • Outstanding interpersonal/communication and mediation skills with ability to effectively partner with a wide group of stakeholders, including professional and medical staff
  • Demonstrated management and leadership skills, including working with varied levels of staff, budgeting, delegation, staff development, coaching, resource allocation planning, and performance management
  • Excellent presentation/public speaking skills and experience
  • Demonstrated ability in development of team focus, partnership, service orientation, influence and change leadership
  • Demonstrated expertise in results orientation, taking initiative
  • Demonstrated awareness of how one's emotions impact decisions, action and desired outcomes
  • Demonstrated awareness in emotional intelligence as modeled in day-to day leadership responsibilities
  • Demonstrated ability to lead, collaborate, communicate, influence and partner effectively with senior leadership and a broad base of business and functional leadership.
  • Strong written and verbal communication skills
  • Proven ability and commitment to work collaboratively in a Labor Management Partnership
  • Demonstrates a level of proficiency in the following tools: Word (compose executive summaries/reports), Excel (open spreadsheets, create graphs), Power Point (create executive presentations), Electronic Medical Record, Statistical Analysis Programs

  • Preferred Qualifications:
    Excellent investigation, problem solving, and documentation skills preferred
    Master's degree preferred.
    Bachelors or Masters Degree strongly preferred.
    Primary Location: California,San Diego,San Diego Medical Center 9455 Clairemont Mesa Blvd Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Working Hours Start: 8:30 AM Working Hours End: 5:30 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Director/Senior Director Job Category: Customer Services Department: Local Member Services Travel: Yes, 20 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

    About Customer Service Careers

    Customer Service Careers

    With over 11 million members, more than 127,000 employees, and over 40 million doctor visits a year, our customer service teams need you to come work with a wide variety of people to address concerns, resolve grievances, and educate our communities about our offerings. At Kaiser Permanente, you'll put your communication and mediation skills to work in support of excellence. We are committed to supporting you with ongoing growth, training, and development opportunities.

    Glassdoor Logo

    See What People are Saying About Working at KP

    Sep 16, 2018

    "Great place to spend a work day"

    Glassdoor Ratings

    Current Employee - Contracts Manager in Oakland, CA

    • Recommends
    • Positive Outlook
    • Approves of CEO

    I have been working at Kaiser Permanente full-time (More than a year)


    Friendly professional people who share insights and work together for improvements and success. Excellent pay and good employee recognition programs.Full Review

    More Kaiser Permanente Ratings & Reviews (3,975)

    to Our

    Kaiser Permanente has been named one of the 2019 Best Places to Work. Check out what our employees like best about working at KP!

    glassdoor 2019 Best Places to Work - Employees' Choice

    Our Events

    Come introduce yourself to a member of the Kaiser Permanente team at an upcoming career or professional event. We look forward to meeting you in person.

    Recently Viewed Jobs

    You do not have any recently viewed jobs.

    Join Kaiser Permanente's Talent Network

    Please fill out the fields below and click "Join Now" to receive information about opportunities that relate to your selections.

    Interested InSearch for a category and select one from the list of suggestions. Search for a location and select one from the list of suggestions. Finally, click “Add” to create your job alert.

    • Customer Services, San Diego, California, United StatesRemove

    Interested in internships or early career opportunities? Click here to join our University Talent Network. Are you a Veteran? Click here to join our Military Talent Network.