Job Type: Full-Time

Status: Exempt

Location: Houston Main Office

Schedule/Shift: Mon-Fri (8am-5pm)

Paid Time Off

401K and matching

FSA

Medical, Dental and Vision Coverage

Company Paid STD/LTD

Company paid Life Insurance

Position Summary

The Customer Care Manager – Under 65 Claims is responsible for overseeing the Customer Care team that manages member and provider inquiries related to healthcare coverage plans, benefits and claims. This role provides leadership and strategic direction to ensure operational excellence, proactive customer satisfaction, and alignment with organizational goals. The Manager serves as the primary escalation point for high-level issues, drives continuous process improvements, and partners with senior leadership to strengthen customer care operations. In addition, the Manager develops and mentors staff, implements performance initiatives, and ensures compliance with company policies and industry regulations.

Duties and ResponsibilitiesTeam Leadership & Development

• Lead, mentor, and develop a team of Customer Service Representatives (CSRs), fostering a culture of accountability, engagement, and professional growth.
• Set clear performance expectations and service standards, ensuring alignment with departmental goals.
• Conduct regular team meetings and individual coaching sessions to drive performance and employee development.
  
  

Operational Management & Escalation Oversight

• Oversee daily operations of the Customer Care team, ensuring adherence to service levels and call handling standards.
• Serve as the final escalation point for complex customer concerns, including claim disputes, benefit clarifications, and authorization inquiries.
• Collaborate with internal departments such as Claims, Policyholder Services, and Underwriting to resolve escalated issues efficiently and accurately.
  
  

Performance & Compliance Management

• Monitor and evaluate CSR performance, identifying trends and implementing improvement strategies.
• Partner with HR and Training teams to address performance issues, enforce policies, and deliver corrective action when needed.
• Ensure compliance with company policies, regulatory requirements, and quality assurance standards.
  
  

Reporting & Data-Driven Insights

• Develop, analyze, and present performance reports to senior leadership.
• Use data to identify operational trends, customer experience gaps, and opportunities for process optimization.
• Recommend and implement strategies to improve efficiency, reduce call volume, and enhance customer satisfaction.
  
  

Strategic Leadership & Collaboration

• Partner with leadership and other senior leaders to influence strategic initiatives within Customer Care.
• Act as a key liaison between frontline operations and executive management, providing insights and recommendations for improving customer experience.
• Lead and support initiatives aimed at improving customer retention, employee engagement, and operational efficiency.
  
  

Qualifications And Skills

Required:

• 35+ years of leadership experience in a call center, customer service, or claims environment.
• Proven track record in team leadership, coaching, and performance management.
• Strong problemsolving and conflictresolution skills with the ability to handle sensitive escalations.
• Excellent verbal and written communication skills, with the ability to influence and build relationships at all levels.
• Strong analytical and reporting skills with the ability to translate data into actionable strategies.
• Proficiency in Microsoft Office applications and call center technologies.
• Ability to manage competing priorities in a fastpaced environment.
• Must be legally authorized to work in the U.S.
  
  

Preferred:

• Experience in the health insurance industry with a strong understanding of claims processing, benefits administration, and authorizations.
• Experience leading multisite or largescale call center operations.
  
  

Education

• High School diploma or equivalent
• Bachelor’s degree in Business, Communications, or a related field (or equivalent experience) preferred.
  
  

Work Environment Requirements

• This role is based in a professional office environment with standard working hours, Monday through Friday, with occasional extended hours during peak periods or high call volume.
• The position requires frequent use of a computer, telephone, and standard office equipment.
• The role involves regular communication with staff, leadership, and customers, requiring the ability to remain focused and composed in a fastpaced, highvolume environment.
• Occasional standing, walking, and lifting of up to 15 pounds may be required (e.g., handling office supplies or equipment).
• The work environment requires adaptability to changing priorities, multiple concurrent tasks, and strict deadlines.
• Minimal travel may be required for training, meetings, or business needs.
• A hybrid or remote work arrangement may be available based on business needs and company policy.