The Director of Continuous Improvement is a strategic and execution-focused leader responsible for driving operational excellence, scalable growth, and member-centered continuous improvement across the Customer Experience (CX) Operations organization within Alignment Health Plan.
This role champions caring, human-centered connections while leading enterprise-wide initiatives to improve efficiency, optimize processes, and enhance service delivery. The Director will oversee a team 2 direct-report Managers and operate within a highly matrixed environment, leveraging subject matter experts (SMEs) across the organization (Operations, Transformation, Appeals/Grievance, Utilization Management, Clinical, Technology, Compliance, and Analytics).
The ideal candidate brings deep expertise in contact center continuous improvement methodologies, data-driven decision making, and technology enablement, coupled with a passion for delivering exceptional member experiences at scale.

Job Duties/Responsibilities:

Continuous Improvement & Operational Excellence

• Identify and lead the design, execution and adaption support of a continuous improvement strategy aligned to CX and enterprise priorities
• Identify, prioritize, and implement initiatives that deliver efficiency gains, cost optimization, and service quality improvements
• Apply industry best practices (Lean, Six Sigma, Agile, or equivalent) to streamline workflows and eliminate waste
• Establish a culture of continuous improvement and accountability across CX Operations

Member-Centered Experience & Caring Connections

• Embed a "caring connections" philosophy into the culture and all process improvements to ensure operational efficiency does not compromise empathy or member experience
• Partner with CX leadership to translate voice-of-customer insights into actionable improvements that enhance member and employee satisfaction, retention, and trust
• Ensure initiatives align with member needs and expectations
• Lead the coordination and operational alignment of cross-functional engagement campaigns and promotions that drive member outreach and coordination.
• Partner with key teams, Marketing, Product, Clinical, Sales, STARs, Training and WFM to ensure campaigns are aligned to member journeys, business priorities, and operational outcomes.

Data-Driven Insights & Performance Management

• Develop and maintain a robust performance measurement framework to track the impact and adaption of improvement initiatives
• Leverage analytics to evaluate processes, identify trends, and inform decision-making
• Define KPIs, dashboards, and reporting mechanisms to monitor efficiency, quality, and member experience outcomes
• Regularly communicate progress, insights, and recommendations to executive leadership
• Track initiatives aligned with ROI model to ensure meeting expectations and value realization

Technology Enablement & Business Transformation

• Define and document business and functional requirements to support technology solutions that improve CX operations and member experience
• Partner with DTS, Digital, Product and cross functional teams to drive tools, automation, and platform enhancements
• Build strong business cases and ROI models to justify investments in technology and process improvements
• Ensure successful implementation, adoption, and value realization of new capabilities

Program & Initiative Management

• Provide end-to-end oversight of key improvement initiatives, including planning, prioritization, execution, and delivery
• Establish governance structures to track progress, manage risks, and ensure accountability
• Oversee the implementation of new processes, ensuring sustainability and measurable outcomes
• Drive cross-functional alignment and execution within a matrixed organizational model
• Manage project execution ensuring milestones met; prepare executive level presentations

Leadership & Team Development

• Lead, mentor, and develop team fostering a high-performance, collaborative and engaged environment
• Build capabilities in continuous improvement, analytics, and change drivers within the team
• Influence without authority across departments, leveraging SMEs to deliver large-scale initiatives
• Promote a culture of caring connections, innovation, inclusivity, and continuous learning

Job Requirements:

Experience:

Required

• Proven track record of delivering measurable operational improvements, member satisfaction and efficiency gains
• Experience leading cross-functional initiatives in a matrixed environment
• Demonstrated experience in data analysis, performance management, and KPI development and tracking
• Experience defining, documenting, tracking deliverables and communicating business requirements and partnering on technology implementations

Preferred:

• Experience in Medicare Advantage or regulated healthcare environments
• Certification in Lean Six Sigma Black Belt or equivalent
• Familiarity with Customer Experience/Dialer platforms, CRM systems, workflow automation, and analytics tools
• Strong understanding of member experience, contact center operations, or service delivery models

Education:

• Required: Bachelor's degree in Business, Healthcare Administration, Operations, or related field.
• Preferred: Master's degree in Business, Healthcare Administration, Operations, or related field

Training:
• Required: None

Specialized Skills:
• Required:

• Exceptional leadership, communication, and stakeholder management skills
• Expertise in process improvement methodologies (Lean, Six Sigma, Agile)

Licensure:
• Required: None
• Preferred: None

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $130,332.00 - $195,498.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.