Director of Customer Service

DETROIT WAYNE INTEGRATED HEALTH NETWORK

Director of Customer Service

GENERAL SUMMARY :

The Director of Customer Service provides strategic and operational leadership for DWIHN's Customer Service Department to ensure timely, compassionate, and effective support to members, providers, and stakeholders. This position ensures compliance with all applicable federal, state, and local regulations, including MDHHS Customer Service Standards, Medicaid Managed Care requirements, and PIHP contractual obligations. The Director drives continuous improvement in service quality, access to care, and member satisfaction across all lines of business, including behavioral health, substance use disorder, and integrated care coordination.

PRINCIPAL DUTIES AND RESPONSIBILITIES :

Strategic and Operational Leadership

• Develop, implement, and evaluate DWIHN's Customer Service strategy in alignment with organizational mission, values, and state requirements.
• Lead the design and delivery of a high-performing customer service model that supports members, families, and providers with timely information, problem resolution, and navigation support.
• Oversee Customer service call center operations, member inquiries, grievances, appeals, and customer satisfaction tracking.
• Ensure compliance with PIHP / MDHHS standards, Medicaid / Medicare guidelines, and applicable accreditation or regulatory bodies.
• Collaborate with departments such as Provider Network, Quality Improvement, Compliance, and Access to coordinate seamless member experiences.

Monitor compliance with the MDHHS contract requirements, including response timeliness, documentation standards, and reporting metrics.

Key Focus Areas

(Performance Expectations)

KNOWLEDGE, SKILLS AND ABILITIES :

DESIRED EXPERIENCE AND TRAINING :

Experience :

Training :

Health Service Administration, Organizational Management,

Business Administration Social Work, Public Health or other related areas.

WORKING CONDITIONS :

Work is usually performed in an office setting but requires the employees to drive to different sites throughout Wayne County and / or State.

The above statements are intended to describe the general nature and level of work being performed by person assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Detroit Wayne Integrated Health Network

October 2, 2025