Compensation Overview

What You’ll Be Doing: 

We are looking for a Contract and Eligibility Operations Sr. Manager to elevate our contract management and execution, optimize pre-service eligibility and authorization workflows, and maintain and improve claim setup to support effective collections throughout the lifecycle of a contract. You’ll be part of the remote-friendly Insurance Operations department reporting directly into the Director of Strategy and Operations. Your responsibilities will include: 

• Lead a team of Associates/Coordinators. Coach them in their day-to-day responsibilities, and stay in sync with leadership on their performance.
• Collaborate with our Revenue Cycle Management, Credentialing, Product, Engineering, and Payor Launch teams to ensure we’re setting up our contracting, eligibility, and authorization systems to maximize efficiency and accuracy to convert contracts to profitable partnerships
• Work closely with other leaders across Insurance Operations and other departments to ensure our contract management system remains effective and accurate. 
• Build tools to support all teams in identifying and operationalizing information required to effectively generate claims.
• Continuously assess and identify areas for improvement, develop improvement plans, and implement solutions to resolve issues at scale
• Constantly ideate on how we can continue to improve our systems so that our Contracting and Eligibility infrastructure continues to scale as we continue to grow
• Contract Inventory Management - Document and maintain all necessary information from new and existing contracts in a timely manner after receipt of new contract or updated information.
• Payor Launch - Ensure all timelines to efficiently launch payors are met by identifying and documenting the necessary information. 
• Eligibility and Claim Generation - Ensure claims structure, eligibility, and other setup requirements are identified and documented to enable accuracy and consistency in billing.
• Team Management - Build and maintain a successful team that can execute on our growing business needs.

Salary range: $122,000-170,000

You’ll Be a Good Fit If: 

• Have 6+ years of experience reviewing and implementing requirements for healthcare payor contracts.
• Are hyper focused on creating the most efficient processes and driving operational improvements with your team. Deep understanding of how processes are connected to driving KPIs.
• Are extremely organized and excel at building out or implementing systems to maintain and enable access to highly specific and technical informationCan solve problems by understanding the root cause and coming up with solutions that work not just for the current state, but that will work under predicted future complexity and growth
• Have a strong track record of juggling multiple initiatives and clear ability to prioritize most important stuff. Highly organized and able to keep projects and priorities on track
• Previous experience building out a team and function
• Bonus: Previous experience with health insurance contracts, healthcare eligibility and authorization workflows, and healthcare claims management.

If you don’t meet every single requirement, but are still interested in the job, please apply. Nobody checks every box, and Grow believes the perfect candidate is more than just a resume.