Healthcare Escalation Supervisor

Job Summary

Healthcare Escalation Supervisor leads a full-time team responsible for resolving member and provider grievances, ensuring compliance with regulations, and improving resolution processes.

Key Responsibilities

• Direct and supervise the investigation of member and provider complaints to determine root causes and corrective actions
• Develop and refine resolution methodologies and ensure compliance with applicable regulations
• Act as the final escalation point for complex issues and manage cross-functional collaboration with Legal and Operations

Required Qualifications

• 3+ years in healthcare contact center operations focused on escalations, grievances, or appeals
• Thorough knowledge of health insurance operations and compliance standards
• Experience with member and provider services escalation processes
• Bachelor's degree preferred or equivalent work experience considered
• Strong team leadership and performance management skills