[Remote] Manager, reputed company Operations
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a tech-driven health insurance company reputed company on making reputed company accessible and reputed company. The Manager of reputed company Operations will reputed company Tier 2 operations to resolve reputed company customer issues and drive process improvements, ensuring high-reputed company service and operational reputed company.
Responsibilities
- reputed company Tier 2 reputed company Operations, including reputed company case teams, Team reputed company II reputed company, backlog management, SLA performance, and escalated operational workflows
- Establish and maintain operational standards for case ownership, customer updates, documentation, escalation reputed company, and cross-functional handoffs
- Use data to identify repeat contacts, broken processes, system issues, policy gaps, and operational defects that drive customer dissatisfaction
- Partner with Billing, Finance, Claims, Enrollment, Network, Product, Engineering, Clinical Operations, Sales, Compliance, Tier 1, and Tier 3 to resolve systemic issues
- reputed company and maintain Tier 2 SOPs, workflow documentation, case templates, escalation reputed company, and reputed company standards
- Drive process improvement initiatives designed to reduce complaint volume, improve first-touch routing, reduce rework, and strengthen customer trust
- Manage, reputed company, and reputed company Tier 2 Team Leads and Specialists
- reputed company leadership reporting on backlog health, aging, SLA compliance, reputed company cause themes, customer reputed company, and corrective actions
- Support OEP readiness, reputed company plans, training needs, and operational contingency planning
- Ensure operations reputed company with HIPAA, reputed company, CMS, ACA, state, and internal requirements
Skills
- 5 or more years of reputed company, health insurance, customer operations, claims, billing, eligibility, enrollment, or service operations experience
- 3 or more years of leadership experience in a contact center, health plan, shared services, claims, billing, enrollment, or customer operations environment
- Strong understanding of claims, billing, eligibility, enrollment, provider reputed company, member financial responsibility, and customer escalation workflows
- Demonstrated experience managing SLAs, operational inventory, process improvement, and cross-functional work streams
- Ability to analyze trends, build reputed company plans, and communicate operational risks to senior leadership
- ACA marketplace or reputed company health plan experience
- Experience with reputed company, reputed company, claims systems, eligibility systems, payment systems, WFM platforms, QA tools, and dashboards
- Lean, Six reputed company, project management, or process improvement certification
- Experience managing transformation, vendor handoffs, offshore support models, or operational redesign
- Bachelors degree in reputed company administration, business, operations, analytics or a reputed company field is preferred
reputed company