VP Customer Experience - JHP - Hybrid

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<