Job Title:
Director (Consumer Services)
Job Requisition ID:

Number of Openings:
1
Shift:
Any (United States of America)
Compensation Details:
$120,000.00

Job Description:

Under supervision, the Director of Consumer Services is responsible leads and oversees the department responsible for receiving, reviewing, and resolving public inquiries related to potential non-compliance by insurance companies. This includes allegations of improper claim handling, delays, or failure to pay valid claims. The role ensures that consumer concerns are addressed promptly, thoroughly, and in accordance with regulatory standards, while maintaining high-quality service to the general public.

Provide strategic leadership and direction to the Consumer Services Department.

Oversee intake, assessment, and resolution of consumer inquiries and complaints involving insurance company compliance with claim payment requirements.

Ensure consistent, fair, and timely review of cases, including coordination with internal compliance teams and external regulatory bodies.

Develop and implement policies, procedures, and performance standards to improve departmental efficiency and service quality.

Monitor trends in consumer complaints and identify systemic issues that may require regulatory attention or industry outreach.

Foster strong relationships with insurers, regulatory partners, consumer advocates, and other stakeholders.

Ensure superior customer service to the general public, providing clear, empathetic communication and guidance throughout the inquiry process.

Maintain effective internal communication to support collaboration, transparency, and alignment across teams.

Prepare reports, presentations, and documentation for executive leadership and regulatory agencies.

Maintain strong relationships with insurers, regulatory partners, and consumer advocacy organizations, ensuring transparent and constructive communication.

Lead, coach, and develop departmental staff to maintain a high-performing and consumer-centered team.

Ensure the department operates in compliance with agency policies, applicable laws, and regulatory guidelines.

Support public education efforts related to insurance rights, claim processes, and complaint procedures.

Lead, supervise, and coach staff; prepare, conduct, and review employee performance evaluations.

Lead cross-functional collaboration to align workflows, improve processes, and address departmental dependencies that affect complaint resolution.

Identify operational inefficiencies and implement solutions that improve turnaround times, quality of case reviews, and customer satisfaction.

Utilize data analytics, including call center metrics, intake patterns, case volumes, and resolution times, to guide staffing decisions, workflow improvements, and performance strategies.

Monitor data to identify issues requiring outreach, education, or regulatory intervention.

Develop and implement training programs to ensure staff are equipped with knowledge of insurance regulations, customer service best practices, investigative procedures, and case management tools.

Continuously evaluate departmental learning needs and update training initiatives accordingly.

Perform other duties assigned.

Minimum Qualifications:
Bachelor's degree in a related field from an accredited college or university and five (5) years in a managerial role in a related field; or two (2) years of experience required at the lower level Sr Mgr, Insurance Investigation (RCM041) or position equivalent.