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This is a fantastic new leadership opportunity for the right person who has been instrumental in transforming the consumer and customer experience across an organization. Health Care has become a very consumer driven industry and there are a great deal of quantified metrics and benchmarks that are measured and monitored that directly correlate to our success. We’re looking for a dynamic leader and change agent who can take this business critical function to the next level. More details follow below and we would love to hear from you if you have enjoyed success in this capacity, even if we start out with an exploratory and confidential conversation.


Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is the only health plan in Massachusetts to have been awarded “Excellent” Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit.


The Director of Consumer Experience is accountable for the definition, development and deployment of a new Consumer Experience strategy, in collaboration with other Fallon stakeholders, that allows Fallon to transform from an ad hoc/reactive approach to a strategic, deliberate and proactive approach with clear outcomes pertaining to customer satisfaction, growth and retention. He/she is responsible for assessing and, where needed, refocuses current work being done through the Service Excellence Committee structure to fall under new strategy. Ensure new strategy captures work to be done to support CMS star ratings initiative, digital strategy, NCQA standards, cultural competency, etc., and supports the maximization of portal/CRM/marketing automation investments.


Establish and Execute Consumer Experience Roadmap (55%)

  • Set an inspirational vision for the organization, working closely with the VOOM team, Service Advisory and others to continuously improve Consumer experience metrics and reporting. Establish clear objectives, goals and milestones for the customer experience strategy.

  • Understands the drivers of Consumer Experience performance and drive actions to improve FH’s score with a specific focus on CAHPS

  • Design a multi-year roadmap to redefine Consumer experience framework and help the company strengthen customer experience management capabilities.

  • Champion a customer experience culture using a common language and definitions at all levels and providing executive visibility around key customer experience metrics.

  • Maintain and ultimately enhance survey processes that create customer experience metric results (currently member experience and provider satisfaction) and define actions to improve over time.

  • Produces and monitors dashboards, trends and surveillance reports for Sr. Management and department leaders and teams. Includes CAHPS, internal monitoring and other sources as appropriate

  • Develops action plans and interventions specifically designed to improve CAHPS performance. Includes successful execution and management working with cross functional teams to implement.

  • Provide a fresh perspective on customer process work and recommendations on cross-functional updates to improve customer engagement programs and activities.

  • Work closely with key cross-functional stakeholders and leaders across the organization to drive required changes to improve customer experience.

  • Provide quarterly analysis and recommendations to the executive team on enhancements to customer experience.

  • Drive execution of identified activities to improve consumer experience. Includes defined success criteria, meeting goals and active monitoring to determine if goals are achieved.

  • Review industry trends routinely for new reporting, analysis and opportunities

  • Improve Consumer Experience performance based on defined internal goals

  • Keep abreast of relevant regulatory (pending and potential) updates. Identify and plan for potential impact to consumer experience

Corporate Leadership (15%)

  • Establish and maintain relationships with senior leaders and business partners, ensuring alignment with strategic priorities.

  • Provide key metrics/reporting to leadership for Consumer Experience Performance

  • Advocate and demonstrate value for Consumer Experience initiatives to Fallon Health management teams

  • Share trends from data collection to areas to identify opportunities for improvements

  • Build collaborative relationships across the organization and with FH customers and business partners

  • Represent FH on external workgroups focused on consumer experience

  • Participate in various Fallon Health workgroups/committees to advocate for Consumer Experience initiatives and recommendations for improvements

Contribute to achievement of Fallon Health financial goals (15%)

  • Ensure customer priorities are considered in planning and budgeting processes.

  • Responsible for adherence to the approved budget and developing the business case for any variances.

Resource Development (15%)

  • Foster development of Fallon Health staff to support the needs of our members for optimal consumer experience via Training, workforce development etc.

  • Initiate actions to foster organizational development and change management activities to ensure high performing work teams.

  • Provide guidance and leadership to colleagues and indirect reports to ensure effective team environments through efficient leadership, motivational and organizational methods.

  • Ensure adherence to established HR practices and protocols, champion teamwork and mutual respect and maintain the highest level of professionalism.

  • Build collaborative relationships across the organization and with Fallon Health customers and business partners


  • 5+ years in customer experience transformation work and Voice of the Customer/Customer Advocacy Programs; health care a plus

  • Ability to see from the customer point of view and championing that view across the company

  • Proven track record for driving significant change/business transformation

  • Experience building trusting relationships and influencing others (incl. executive audiences)

  • Excellent planning skills through devising plans and strategies to move projects and the organization forward to enhance our consumer experience ratings.

  • Consumer experience design and development preferred (including in the digital space)

  • Results- and outcome-oriented program management experience

  • Ability to shift from developing high level strategies to effective execution, influencing at every level, and driving decisions through appropriate collaboration

  • Effective communicator, able to convey complex ideas in a clear, concise manner both verbally and in writing; comfortable in business and technical discussions

  • Demonstrated effectiveness bridging technology & business perspectives to collaboratively achieve shared project objectives

  • Knowledge of Medicare, Medicaid and Commercial regulations, legislation and laws, auditing reports and system functions preferred

  • Advanced skills in analytics and problem solving


Job ID 5742

# Positions 1

Category Data Management/Reporting