Apply on Employer Site

L.A. Care Health Plan · 12 hours ago

Manager, Customer Engagement and Experience Quality Assurance

Los Angeles, CA

Full-time

Onsite

Mid, Senior Level

$89K/yr - $142K/yr

4+ years exp

L.A. Care Health Plan is the nation’s largest publicly operated health plan, dedicated to providing health coverage to low-income residents of Los Angeles County. The Manager of Customer Engagement and Experience Quality Assurance is responsible for leading quality oversight and service excellence within the health plan’s customer experience operations, ensuring high-quality support to members and driving initiatives for service improvement.

FitnessGovernmentHealth Care

Responsibilities

Leads the development, execution, and continuous enhancement of the customer experience QA program

Creates and maintains QA scorecards, evaluation criteria, scripts, and standards aligned with health plan policies and regulatory requirements

Conducts regular calibrations with supervisors and operational leadership to ensure scoring consistency and fairness

Evaluates all forms of member interactions for accuracy, empathy, compliance, and resolution quality

Monitors and interprets trends in member experience metrics, including CAHPS, satisfaction surveys, complaints, and grievance themes

Identifies root causes of negative member experiences and recommends targeted solutions

Leads initiatives that improve first call resolution, member education, clarity of communication, and service recovery effectiveness

Supports culturally sensitive and health-literate communication practices across customer experience service teams

Works closely with customer experience leadership to provide recommendations for process improvements, workflow optimization, and service protocols

Tracks performance outcomes and collaborates on coaching plans for teams and individuals

Provides timely feedback to supervisors and frontline staff to reinforce excellence and correct deficiencies

Partners with Training/Learning and Development to design onboarding and ongoing training aligned with QA findings

Ensures training content reflects service expectations, regulatory updates, and quality standards

Facilitates QA refresher sessions, coaching workshops, and service excellence training as needed

Prepares QA documentation and evidence for regulatory reviews, internal audits, and accreditation surveys

Supports the development and monitoring of corrective action plans when compliance issues arise

Develops and maintains dashboards and reports that track QA outcomes, experience trends, and service performance

Presents insights to leadership, identifying risks, opportunities, and actionable recommendations

Monitors Key Performance Indicators (KPIs) such as call accuracy, empathy quality, service level impact, error rates, and first call resolution

Partners cross-functionally to align on experience strategy

Participate in cross-functional initiatives to improve end-to-end customer experience and streamline the member journey

Serves as a subject matter expert on service quality, customer engagement, and experience-driven best practices

Conducts development planning

Fosters a culture of accountability, team collaboration, and service excellence

Manage staff, including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others

Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval

Responsible for reporting, budgeting, and policy implementation

Performs other duties as assigned

Qualification

Customer service operationsQuality assuranceLeadership skillsHealth plan operationsAnalytical skillsData analysisCommunication skillsCoaching skillsStrategic planningBudget managementContinuous improvementRoot-cause analysisService quality frameworksMarket analysisFacilitation skillsInterpersonal skillsOrganizational skillsConflict resolutionPresentation skillsTeamwork

Required

Bachelor's Degree

At least 4 years of experience in customer service operations within a health plan or healthcare environment

At least 3 years of experience in leading, supervising and/or managing staff

At least 3 years of experience in quality assurance, customer experience, or service excellence

Experience leading teams, projects, initiatives, or cross-functional groups

Strong understanding of health plan operations, benefits, and regulatory standards

Excellent analytical, quality auditing, and reporting skills

Ability to translate data into insights and actionable performance improvements

Exceptional communication, coaching, and facilitation skills

Strong leadership skills and ability to motivate and support teams

High attention to detail and organizational skills

Proficiency in MS suite

Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment

Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision

Skilled in mediating disputes and resolving conflicts in a fair and constructive manner

Must have a deep understanding of financial principles

Ability and excellent knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation

Demonstrated ability to make informed decisions

Strong verbal, written communication and presentation skills

Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges

Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals