Job Details

Job Details
The Vice President of Customer Experience (CX) leads a member-focused strategy across Medicaid, Medicare, ACA, CHIP, and MLTSS, overseeing customer service operations and the member call center. This role drives service excellence through multi-channel engagement, process improvement, and evidence-based onboarding. The VP ensures regulatory compliance, equitable access, and cultural responsiveness while aligning cross-functional efforts to improve satisfaction and retention. Key priorities include quality management, workforce planning, operational efficiency, and technology adoption. Success is measured by service quality, compliance, performance metrics, and strategic impact.

Job Description

• Develop and implement a unified CX strategy aligned with the organization's mission and the unique needs of each line of business.
• Define and operationalize key member journey touchpoints, including onboarding, redetermination, grievances, and care navigation.
• Partner across functions to embed service excellence and drive a member-first culture throughout the organization.
• Lead initiatives to improve CAHPS, NPS, grievance rates, and call center satisfaction.
• Design outreach and engagement models to increase redetermination, recertification, preventive care, and value-added service utilization.
• Collaborate with Training and Quality teams to embed service standards across all member-facing functions.
• Launch coaching, recognition, and feedback programs to increase frontline engagement and accountability.
• Champion equitable service delivery across language, geography, culture, and ability.
• Collaborate with DEI and Health Equity leaders to assess and reduce disparities in CX outcomes.
• Build and maintain CX dashboards to monitor KPIs across all channels and product lines.
• Leverage member feedback, survey data, call trends, and complaints to drive continuous improvement and innovation.
• Lead and manage a high-performing team of directors and managers.
• Oversee the implementation of quality monitoring, service recovery, member education, and escalation protocols.
• Serve as the CX lead for regulatory audits, accreditations (e.g., NCQA), and enterprise transformation efforts.
• Partner with IT, Digital, and Marketing to enhance self-service tools and expand omnichannel support.
• Performance Metrics:
  • CAHPS score improvements (e.g., "Getting Needed Care," "Customer Service")
  • Net Promoter Score (NPS) by line of business
  • Call Center Satisfaction Score (CSAT) targets
  • Year-over-year grievance and appeal reduction
  • Member retention across Medicaid, Medicare, and ACA
  • Preventive services utilization (e.g., well-child visits, wellness exams)
  • Timely redetermination/recertification completion rates
  • Complaint resolution times in regulatory compliance
• Develop strategic, operational, and tactical plans to achieve business goals.
• Drive member growth and retention through exceptional service delivery.
• Balance workload and demand across service channels to optimize the member experience.
• Recruit, develop, and retain a high-performing team; foster a culture of accountability, innovation, and excellence.
• Monitor and improve performance through coaching, metrics, and process improvement.
• Maintain strong internal and external relationships to support business outcomes.
• Manage departmental budget and ensure alignment with financial and service goals.
• Other duties as assigned.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education:

• Bachelor's degree in business, Public Health, Healthcare Administration, or related field required
• Master's degree in healthcare administration, Business, or related field preferred

Experience:

• 10+ years of progressive leadership experience in managed care or healthcare customer service
• Deep knowledge of Medicaid, Medicare, MLTSS, CHIP, and ACA requirements and populations
• Demonstrated success leading CX transformation initiatives
• Proven experience managing cross-functional teams and operationalizing strategy

Preferred:

• Experience with NCQA accreditation or CAHPS strategy development
• Background in community-based or member advocacy work
• Bilingual or multilingual proficiency is a plus
• Fifteen years' experience in multi-product healthcare insurance setting with a minimum of 10 years in a senior level management position

#LI-Hybrid

Work Shift
Workday Day (United States of America)

Worker Sub Type
Regular

Employee Entity
Health Partners Plans, Inc.
Primary Location Address
1101 Market, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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