Keren Santamaria
Highland,CA
Summary
Dynamic Member Services Leader with a robust background in enhancing member experience through innovative operational strategies, advanced contact center technology, and comprehensive training programs. Expertise in optimizing customer engagement platforms and driving operational efficiency, resulting in significant improvements in service quality and member satisfaction. Acknowledged for cultivating high-performing cross-functional teams that consistently deliver measurable enhancements in service levels, call quality, and compliance across member experience operations. Committed to leveraging technology solutions to elevate organizational performance and foster a culture of excellence.
Overview
2027
2027
years of professional experience
Work History
Member Services - Call Center Manager
IEHP
01.2017 - Current
- Manage a high-volume healthcare contact center operation team of 100+ Member Service Representatives, consistently aligning resources to attain service level ASA and abandonment rate key performance metrics.
- Collaborated with cross-functional teams to formulate and present strategies for executing the DSNP member communication plan focused on Member-facing mailings, FAQs, training materials, IVR, self-service platforms, and digital SMS communications to improve Member education and understanding.
- Collaborated with cross-functional teams to formulate and present strategies for executing DSNP member communication plan focused on Member-facing mailings, FAQs, training materials, IVR, self-service platforms, and digital SMS communications to decrease DSNP inbound member call volume by 12% for 2024 to 2025 benefit year.
- Developed and executed quality-driven training strategies for CAHPS quality improvement - Quality Training 101, Care Advocate Outreach Proactive Concierge Training, Value-Based Customer Service Training, and CAHPS outreach quality-driven FAQ and talking points.
- Designed VOM surveys to effectively measure net promoter scores and FCR, embedding CAHPS and CMS stars terminology to boost quality-centered DSNP Member experiences, achieving marked improvements in member satisfaction through collective departmental initiatives.
- Spearheaded training development to improve grievance identification while collaborating with cross-functional teams to resolve root cause issues, achieving a grievance reduction of 21.3% in 2023 to 2024.
Member Services Supervisor
IEHP
2012 - 01.2017
- Directed daily operations for IEHP's Medi-Cal and Medicare D-SNP inbound and outbound call queues, maintaining consistent service standards and operational effectiveness.
- Developed, engaged, and coached a team of 20+ member services call center staff to uphold quality performance metrics above 90%
- Partnered with internal departments to identify opportunities and implement improvements to call center processes and core operational workflows.
Member Services Representative
IEHP
07.2011 - 01.2012
- Resolved Member issues through effective communication and problem-solving techniques.
- Educated Members on services and benefits, promoting engagement and retention strategies.
- Conducted follow-up email communications to ensure resolution of member concerns and feedback collection.
Education
Master of Science - Public Administration
California Baptist University
Riverside, CA08-2025
Bachelor of Science - Biological Science
Cal State University Fullerton
Fullerton, CA01-2010
Skills
- Member Experience Strategy
- Leadership & Accountability
- Training Strategies & Execution
- Business System & Technology Optimization
- Knowledgeable in Quality Standards, CAHPS, & CMS Stars
- Cross-Functional Leadership & Vendor Management
- Self-Service & Call Routing Optimization
- Reporting & Dashboard KPI Development
- Planning & Execution of User Acceptance (UAT)
- Knowledgeable in Medi-Cal and Medicare Processes and Call Flows
Accomplishments
- 2026- Implemented concierge CARE Advocate Team strategy for new and at risk DSNP Members resulting in improved Member experience, engagement, satisfaction.
- 2026 Implemented contact center data-driven Self-Service IVR design for Medi-Cal and DSNP Call Centers resulting in call reduction and Member satisfaction.
- 2025 - Silver Award LEAN Recipient Vibrant Health Strategies: call reduction, reduced operational cost.
Timeline
Member Services - Call Center Manager
IEHP
01.2017 - Current
Member Services Representative
IEHP
07.2011 - 01.2012
Member Services Supervisor
IEHP
2012 - 01.2017
Master of Science - Public Administration
California Baptist University
Bachelor of Science - Biological Science
Cal State University Fullerton