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Director Operations Member Services

Kaiser Permanente

Customer Support and Service Jobs

Director Operations Member Services

full-timePosted: Jan 13, 2026

Job Description

Job Summary:

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 members 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.

Locations

  • Downey, California, United States

Salary

Estimated Salary Rangemedium confidence

130,000 - 220,000 USD / yearly

Source: ai estimated

* This is an estimated range based on market data and may vary based on experience and qualifications.

Skills Required

  • Leadership and managementintermediate
  • Issue resolutionintermediate
  • Data analysisintermediate
  • Service recoveryintermediate
  • Performance consultingintermediate
  • Budgetary oversightintermediate

Responsibilities

  • Provide leadership to Member Services staff
  • Oversee daily operations and case processing
  • Identify pain points and drive improvements
  • Act as liaison with medical group
  • Handle high-risk issues
  • Provide reports and recommendations

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Tags & Categories

Leadership and managementIssue resolutionData analysisService recoveryPerformance consultingBudgetary oversightHealthcare

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Kaiser Permanente logo

Director Operations Member Services

Kaiser Permanente

Customer Support and Service Jobs

Director Operations Member Services

full-timePosted: Jan 13, 2026

Job Description

Job Summary:

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 members 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.

Locations

  • Downey, California, United States

Salary

Estimated Salary Rangemedium confidence

130,000 - 220,000 USD / yearly

Source: ai estimated

* This is an estimated range based on market data and may vary based on experience and qualifications.

Skills Required

  • Leadership and managementintermediate
  • Issue resolutionintermediate
  • Data analysisintermediate
  • Service recoveryintermediate
  • Performance consultingintermediate
  • Budgetary oversightintermediate

Responsibilities

  • Provide leadership to Member Services staff
  • Oversee daily operations and case processing
  • Identify pain points and drive improvements
  • Act as liaison with medical group
  • Handle high-risk issues
  • Provide reports and recommendations

Target Your Resume for "Director Operations Member Services" , Kaiser Permanente

Get personalized recommendations to optimize your resume specifically for Director Operations Member Services. Takes only 15 seconds!

AI-powered keyword optimization
Skills matching & gap analysis
Experience alignment suggestions

Check Your ATS Score for "Director Operations Member Services" , Kaiser Permanente

Find out how well your resume matches this job's requirements. Get comprehensive analysis including ATS compatibility, keyword matching, skill gaps, and personalized recommendations.

ATS compatibility check
Keyword optimization analysis
Skill matching & gap identification
Format & readability score

Tags & Categories

Leadership and managementIssue resolutionData analysisService recoveryPerformance consultingBudgetary oversightHealthcare

Answer 10 quick questions to check your fit for Director Operations Member Services @ Kaiser Permanente.

Quiz Challenge
10 Questions
~2 Minutes
Instant Score

Related Books and Jobs

No related jobs found at the moment.