Sendero Customer Service — Comprehensive Operational Guide

Overview and strategic objectives

Sendero customer service is best approached as a revenue-protecting and retention-focused function rather than a cost center. The primary objective should be to reduce churn, increase lifetime value (LTV), and convert service interactions into opportunities for upsell and advocacy. Practically, that means prioritizing measurable targets: reduce monthly churn by 15–25% year-over-year, lift Net Promoter Score (NPS) by 10–20 points within 12 months, and achieve a Customer Satisfaction (CSAT) average of 4.5/5 across channels.

To achieve those goals, align service KPIs to business outcomes and embed customer service in product and sales roadmaps. Routine cross-functional rituals — weekly ticket reviews with product, monthly escalations reviews with engineering, and quarterly roadmap alignment with sales — ensure customer feedback directly informs product fixes and feature prioritization. Document these cadences and assign owners for each action item to ensure closure within agreed deadlines.

Channels, service-level agreements (SLAs), and response philosophy

Sendero should support an omnichannel customer experience: phone, email, live chat, in-app messaging, and a self-service knowledge base. Phone and chat handle time-sensitive issues; email and ticketing handle complex or asynchronous cases; knowledge base and tutorials reduce inbound volume. Implement channel-routing rules that favor first-contact resolution (FCR): urgent incidents go directly to senior agents, account-specific queries route to named account owners, and general product questions route to tier-1.

Define clear SLAs tailored to channel and severity. SLAs must be public to customers (on a support page) and private for internal tracking. Share SLA performance weekly and publish SLA breaches monthly with root-cause analysis and remediation plans.

• Recommended SLA & KPI targets (illustrative): First Response Time — Phone/Chat: <2 minutes; Email/ Ticket: <2 business hours; Severity 1 (service-down): initial response <15 minutes, full resolution target <4 hours. First Contact Resolution: >70%. CSAT: >4.5/5. NPS: >40. Ticket backlog per agent: <25 active tickets. Escalation acknowledgement: <1 hour.

Team structure, roles, and training

Design a layered support organization: Tier 1 (generalists), Tier 2 (technical specialists), Tier 3 (product/engineering partners), and Customer Success Managers (CSMs) for strategic accounts. Ratio guidance: for a SaaS business with average revenue per user (ARPU) of $100/month, plan roughly 1 CSM per $150–300k ARR and 1 support agent per 150–400 active customers depending on ticket volume. For high-touch enterprise segments, increase coverage and introduce named support engineers.

Invest in role-specific training that combines product mastery, soft skills, and troubleshooting frameworks. Create a 30-60-90 day onboarding curriculum: 30 days — product fundamentals and shadowing; 60 days — handle low-complexity cases with coaching; 90 days — independently manage complex escalations. Maintain an internal certification (renew annually) and require pulse-testing against real tickets (score >85% to remain certified).

Tools, workflows, and automation

Operational reliability depends on a modern toolchain: a shared ticketing system (e.g., Zendesk, Freshdesk, or a custom ticketing DB with APIs), unified customer data platform (CDP) or CRM (Salesforce, HubSpot) integrations, and a knowledge base with analytics. Use a status page (public) to broadcast incidents, and a private incident management tool (PagerDuty, Opsgenie) for severity-1 handling. Ensure a single source of truth for customer context (open orders, billing history, product version) accessible within 2–3 clicks from the ticket interface.

Automate repetitive tasks to reduce cost-per-contact: automated triage using keywords and metadata, canned responses for frequent issues, SLA timers and escalation rules, and auto-closure for stale low-priority tickets after a defined workflow. Track automation outcomes and maintain a change log to prevent regressions.

• Suggested workflow and automation stack: Ticketing + Macros (Zendesk/Freshdesk), CRM integration (Salesforce/HubSpot), Knowledge Base (HelpDocs/Confluence), Incident Management (PagerDuty), Chatbot for 24/7 basic triage, Analytics (Looker/Power BI), Call recording and QA tool, and a scheduled sync (daily) that pushes critical tickets to Slack channels for rapid visibility.

Metrics, reporting, and continuous improvement

Report a balanced scorecard weekly and deep-dive monthly: volume by channel, SLA attainment, FCR, CSAT by product area, NPS by cohort, average handle time (AHT), and ticket reopen rate. Use cohort analysis to track how support improvements impact retention and expansion; for example, compare retention rates of customers who received proactive outreach in the first 90 days vs. those who did not.

Implement a closed-loop feedback system: tag tickets by root cause, route product bugs to engineering with severity and customer impact, and require a response within a defined timeline (e.g., engineering reply within 5 business days). Publish quarterly “Voice of the Customer” reports with prioritized improvements and track completion rate (%) of promised fixes.

Pricing, escalation paths, documentation, and compliance

Offer tiered support packages: Basic (included): email support, 48–72 hour response time; Standard ($49–99/month seat): 24-hour response, chat support, knowledge base access; Premium ($199–499/month seat): 24/7 phone support, dedicated CSM, priority SLAs. Clearly document what is included per tier and use SLOs/SLA credits for missed commitments. Display package details on a public support pricing page (use your domain, e.g., support.sendero.example.com).

Define a formal escalation matrix with named owners, contact methods, and maximum acknowledgment times for each escalation level. Maintain up-to-date documentation for data privacy and legal compliance (GDPR, CCPA) mapping exactly which customer fields are stored, retention periods, and whom to contact for data subject requests. Keep a public privacy and support policy page and an internal runbook for compliance requests to ensure timely fulfilment.

Is BCBS 24 hour customer service?

Customer Care Representatives are available 24 hours a day, 7 days a week.

Who is the CEO of Sendero Health Plans?

Sharon Alvis has joined the company as Chief Executive Officer. Previously, Alvis was Market President Curative.

What number is 1 800 541 5555?

The Medi-Cal Telephone Service Center (TSC) toll-free number is 1-800-541-5555. TSC is available 8 a.m. to 5 p.m., Monday through Friday, except holidays. For border providers and out-of-state billers billing for in-state providers, please call (916) 636-1200.

What is Metroplus NY customer service number?

Our Member Services team is always here to help.
Just call 1.800. 303.9626 (TTY:711). Our 24/7 Customer Service Hotline will answer your call at other times and on holidays.

What does Medicaid not cover?

Non-Prescription Drugs and Health Supplements
In many states, Medicaid won’t pay for non-prescription drugs, such as painkillers, over-the-counter allergy medicine, and cold remedies. These medicines are available for everyone to buy and aren’t covered under insurance programs.

How do I speak to Medicaid customer service?

★ Department of Health Care Services

1. California State Contacts.
2. Eligibility.
3. Enrollment.
4. ☎ Call the Medi-Cal Helpline: 800-541-5555, or 916-636-1980.