Director, Staffing Transformation & Operations

Key Responsibilities

• Own the multi‑year Member Care staffing strategy across channels, roles and staffing type, ensuring alignment with company growth plans, product roadmap, and client commitments.

• Translate demand forecasts into clear capacity, staffing, skilling, and scheduling requirements across internal and outsourced teams.

• Lead the workforce management function, including long-term capacity planning, short-term staffing plans, schedule design, skilling, real-time management, and feedback loops between plan and actual performance.

• Evolve the staffing model through segment-based role design, cross-skilling, and routing strategy to improve service delivery, efficiency, and employee experience.

• Define the next phase of the staffing model in an AI-forward environment, including how work should shift away from purely inbound, next-available handling.

Vendor Management

• Own Member Care’s current and long term vendor strategy- who we partner with, how and for what defined value

• Proactively identify and mitigate vendor and operational risk through contingency planning, diversification, and surge or outage coverage strategies.

• Define and maintain performance standards and KPIs for vendor partners (e.g., service levels, quality, MSAT, AHT, escalation rates, adherence, error rates, unit cost).

• Oversee the management of BPO relationships.

• Ensure BPO partners are trained, enabled, and informed at the same standard as internal teams by coordinating with Training, Knowledge, Quality Coaching, and Product/IT.

• Partner with Legal, Procurement, IT, Cyber Security and Finance on contracting, pricing, tech enablement, security and commercial terms, ensuring we can meet both performance and margin goals.

• Build and maintain a robust issue and escalation management process with vendors, ensuring clear ownership, timely root cause analyses, and durable corrective actions.

• Ensure systems are set up for accurate invoice reconciliation with our vendors

AI Enablement, Productivity, & Tooling
 

• Own and centralize the Member Care AI enablement roadmap into one prioritized view of opportunities, bets, and expected impact.

• Partner across Product, Engineering, IT, and Operations to identify, prioritize, and scale AI and automation opportunities that improve frontline workflows and member experience.

• Modernize how productivity is defined and measured so it better reflects complex, non-queue-based work and AI-augmented service delivery.

• Use data and structured experimentation to refine staffing models, routing strategies, partner allocations, and AI priorities.

 
Operational Performance, Analytics, & Tooling

• Own a core set of staffing, productivity, vendor, and financial performance metrics, including service level, staffing efficiency, occupancy, utilization, adherence, quality, unit cost, and BPO versus internal mix.

• Partner with Analytics and Finance to connect demand, capacity, staffing decisions, service outcomes, and financial results in a way that supports better in-year decision-making.

• Collaborate with Product, Engineering, and IT on tooling requirements related to IVR, chat routing, WFM platforms, skills management, and reporting, ensuring systems support the complexity of the staffing model.

• Drive a disciplined test‑and‑learn approach to staffing (e.g., pilots on tiering, routing strategies, channel mix, BPO vs. internal allocations) and ensure learnings are documented and institutionalized.

 
Leadership, People Development, & Culture

• Lead, coach, and develop a high‑performing team that includes ICs and people-managers.

• Set a clear vision, strategy, and roadmap for the staffing and vendor management function, with defined milestones and success metrics over an 18‑month horizon.

• Foster a culture of partnership, transparency, and shared accountability across all cross‑functional partners.

• Represent the company’s staffing and vendor strategy in executive leadership forums and, as needed, in client, prospect, and RFP settings.

Cross-Functional Collaboration

• Partner closely with Staffing Forecasting to align on forecasting assumptions, surge plans, and tooling needed to execute the staffing strategy.

• Collaborate with Member Care Advocacy and Service Excellence to ensure staffing and vendor decisions reflect member experience goals, escalation themes, and quality insights.

• Work with Operations Enablement and Project Management on the staffing implications of new clients, new products, and major operational changes (e.g., routing redesigns, new service lines).

• Coordinate with Finance on budget planning, margin improvement initiatives, and unit cost tracking tied to staffing and vendor performance.

• Partner with Client Success and Sales to help explain our staffing and vendor strategy to clients and prospects, as needed, including in RFP responses, client design sessions, and client business reviews.

Qualifications

• 10+ years of experience in staffing strategy, operating model design and/or transformation or a related operational strategy function, including at least 2 years in a people management role.

• Consulting background, particularly in strategy, operations, or transformation work, is strongly preferred.

• Proven experience leading cross-functional operating model or service transformation initiatives in a high-volume, multi-channel environment.

• Experience partnering with senior leaders across operations, finance, product, technology, and external partners to drive complex operational change.

• Experience leading technology-enabled transformation, including AI, automation, workflow redesign, or tooling modernization.

• Experience in healthcare, health benefits, or another highly regulated service environment strongly preferred.

Skills:

• Exceptional strategic and systems thinking, with the ability to connect forecasts, staffing levers, service design, technology investments, and business outcomes.

• Strong analytical and commercial judgment, with comfort working with complex operational and financial datasets and making tradeoff decisions tied to service, savings, and execution risk.

• Ability to lead enterprise change through influence and align cross-functional stakeholders in environments where authority is shared.

• Strong judgment in identifying, prioritizing, and scaling AI, automation, and workflow redesign opportunities based on operational and business impact.

• Clear and confident communication, including experience presenting to senior leaders, executive forums, and external partners.

Education:

• A Bachelor’s degree is required. A degree in Business, Operations Research, Statistics, Industrial Engineering, Healthcare Administration, or a similar field is preferred.

• Advanced degree (e.g., MBA, MHA, MS in Operations Research or Analytics) is a plus.

Additional Requirements:

• Ability to work in a fast‑paced, dynamic environment with competing priorities and tight timelines.

• Interest for Included Health’s mission to raise the standard of healthcare for everyone.

• Willingness to travel up to 10-20% as needed for key internal meetings, site visits, and vendor/client engagements.

Physical / Cognitive Requirements: