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Guidehealth

Optimizes healthcare provider revenue with ML

Client Business Manager

Full-TimePosted on 9/29/2026
$65k - $70k/yr+ 3% employer 401(k) match
Mid
Bachelor's, Associate's
Chicago, IL, USA
RemoteRemote role with approximately 25% travel required in the Chicago area.

About the job

Requirements
  • An associate degree or equivalent experience; a bachelor's degree is preferred.
  • At least 3 years of experience in healthcare operations, managed care, IPA operations, health plan operations, or a related field.
  • Experience owning or meaningfully contributing to client-facing operational work with demonstrated accountability for outcomes.
  • Ability to communicate verbally and in writing with clients, health plan partners, and cross-functional teams, including active listening and running structured client meetings.
  • Strong organizational skills and ability to track multiple workstreams, deadlines, and deliverables across a client portfolio.
  • Strong analytical and problem-solving skills for resolving operational issues across multiple functions and stakeholders.
  • Ability to independently manage a client portfolio and competing priorities in a fast-paced environment.
  • Proficiency in Microsoft 365, including Excel, Word, PowerPoint, Outlook, and Teams, and ability to learn multiple systems.
  • Valid driver's license and reliable transportation.
  • Ability to travel approximately 25% in the Chicago area.
Responsibilities
  • Own client onboarding, ongoing operational support, and service delivery for assigned clients from go-live through steady state.
  • Build and maintain relationships with client administrators, network providers, and management teams to support satisfaction and retention.
  • Manage operational delivery of delegated services, including Eligibility, non-clinical Utilization Management, Population Health Management, Claims, Quality, Customer Experience, and Credentialing/Provider Relations.
  • Serve as the primary point of accountability for delegated-function performance.
  • Ensure regulatory and contract compliance across assigned clients.
  • Prepare and deliver monthly delegated-services reports and quarterly executive-review materials.
  • Support URAC, HCAPA, and health-plan pre-delegation audit preparation.
  • Track, analyze, and report operational data and performance metrics monthly using company applications and reporting tools.
  • Identify trends and drive issues to resolution across internal functions.
  • Own eligibility, capitation, and reconciliation processes, coordinating with Finance and Eligibility to resolve discrepancies.
  • Contribute to new-client implementations, scope expansions, platform transitions, network builds, accreditation renewals, and cross-client initiatives.
  • Track service-level agreement performance against contract requirements, identify gaps, drive remediation, and report status to clients and internal leadership.
  • Lead client operational meetings and participate in Utilization Management committees, JOCs, and monthly close meetings.
  • Conduct regular client check-ins, satisfaction reviews, and quarterly executive business reviews; track CSAT and NPS against annual targets.
  • Serve as escalation owner for claim denials, authorization issues, eligibility questions, provider complaints, roster discrepancies, payment issues, and other client operational issues.
  • Support renewal cycles, including SLA restructuring, PMPM negotiation input, scope expansion proposals, and BAA updates; track assigned clients in the Renewals Master Tracker.
  • Represent Guidehealth at BCBSIL summer and winter forums and translate regulatory and program changes into operational actions.
  • Maintain accurate client contract documentation, DORs, SOWs, and SLA schedules.
  • Contribute to operational improvements, including paper-claims reduction, EFT/ERA adoption, OON reduction, and denial workthrough initiatives.
  • Manage daily work using EMR systems, payer portals, Guidehealth applications, and Microsoft 365.
  • Collaborate with internal teams to deliver integrated services and a consistent client experience.
  • Follow security policies and procedures to protect PHI, PII, and company intellectual property.
  • Remain accessible during stated working hours and participate in virtual meetings with cameras on.
Desired Qualifications
  • Direct experience with delegated services such as Utilization Management, Claims, Credentialing, Eligibility, Population Health Management, Quality, or Customer Experience in an IPA, health plan, or delegated-entity setting.
  • Familiarity with value-based care contracts, including shared savings, full risk, capitation, and PMPM-based service arrangements.
  • Experience with SLA tracking, contract-compliance reporting, and health-plan or NCQA/URAC audit preparation.
  • Familiarity with claims workflows, 834 eligibility files, capitation reconciliation, and payer portals.
  • Experience presenting operational and executive-level reporting to client leadership.
  • Basic knowledge of EMR systems and healthcare data platforms.

About the company

Glide Health helps healthcare providers improve their finances by offering software and consulting to optimize revenue cycles. Its main product is a System of Revenue Intelligence that uses machine learning to review hundreds of millions of insurance claims. It identifies why claims are denied or underpaid and suggests actions to fix the issues, speeding up payments and lowering costs. The product is delivered as a subscription software platform plus consulting services. Glide Health differentiates itself by combining data-driven insights from large-scale claim analysis with hands-on consulting to reduce net denials by up to 60% and tackle challenges like prior authorizations, especially for specialties such as oncology and ophthalmology. The company’s goal is to help providers strengthen cash flow and financial stability so they can focus more on patient care.

Company Size

51-200

Company Stage

Early VC

Total Funding

$24M

Headquarters

Dallas, Texas

Founded

2019

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Simplify's Take

What believers are saying

  • Memorial Hermann led Guidehealth’s $10 million strategic investment, validating the platform in 2024.
  • Emory’s collaborative targets 350,000 patients, expanding Guidehealth’s installed base and referenceability.
  • KLAS 2026 ranked Guidehealth among top VBC enablement firms, strengthening enterprise sales.

What critics are saying

  • Emory and Memorial Hermann concentration creates revenue dependence on a few health-system buyers.
  • AI-enabled care navigation faces incumbents like Aledade and Privia compressing differentiation by 2026.
  • If value-based contracts disappoint, Guidehealth’s services-heavy model stalls before national expansion.

What makes Guidehealth unique

  • Guidehealth combines AI workflows, human Healthguides, and value-based care operations.
  • Arcadia’s value-based care division acquisition gave Guidehealth embedded managed-services capabilities and patient scale.
  • URAC AI accreditation and Emory partnership signal credible clinical-operational differentiation.

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Benefits

Remote Work Options

Flexible Work Hours

Health Insurance

Wellness Program

Mental Health Support

Growth & Insights and Company News

Headcount

6 month growth

↑ 2%

1 year growth

↑ 3%

2 year growth

↑ 10%
PR Newswire
Aug 3rd, 2026
URAC announces first organizations to earn Health Care AI Accreditation.

URAC announces first organizations to earn Health Care AI Accreditation. Aug 03, 2026, 09:00 ET Guidehealth, RediMinds and SandsRx set a new benchmark for responsible AI governance in health care WASHINGTON, Aug. 3, 2026 /PRNewswire/ - URAC, the nation's leading independent health care accreditor, announced that Guidehealth, RediMinds and SandsRx are the first organizations to earn URAC's Health Care Artificial Intelligence Accreditation, marking an important milestone in establishing independent standards for responsible AI governance across health care. URAC launched its Health Care AI Accreditation in 2025 to provide developers and users of AI in health care with a framework for responsible implementation. The program evaluates governance, transparency, risk management and ongoing oversight to help organizations protect patients, support clinicians and maintain public trust. As AI adoption accelerates, the accreditation provides independent validation that organizations have what's needed to deploy these technologies responsibly. The first accredited organizations reflect the broad range of health care entities adopting AI: * SandsRx, a nationally recognized specialty pharmacy, earned the accreditation for its use of AI to improve operational efficiency and scale patient services while maintaining safeguards for patient safety and privacy. * Guidehealth, a health care technology and services company, earned the accreditation as both an AI developer and user for its AI-enabled solutions supporting value-based care and population health. * RediMinds, a technology and AI consulting firm specializing in health care, earned the accreditation as both an AI developer and user for the technologies supporting its Center for Independent Dispute Resolution. "As artificial intelligence plays a larger role in health care, organizations need more than innovative technology; they need governance that helps them deploy AI safely, ethically and transparently," said Shawn Griffin, MD, President and CEO of URAC." These organizations are setting an important example by demonstrating that innovation and accountability can go hand in hand. We congratulate Guidehealth, RediMinds and SandsRx for leading the industry and helping establish greater trust in how organizations use AI throughout health care." For SandsRx, the accreditation reinforced that responsible AI use is an extension of patient care. "As a specialty pharmacy, our reputation is built on delivering exceptional patient service while protecting sensitive health information," said Stephen McGee, Executive Vice President, Chief Compliance Officer at SandsRx. "URAC's AI Accreditation challenged us to strengthen how we evaluate, monitor and govern AI technologies across our organization. It gave us greater confidence that we're using AI to improve efficiency without compromising patient safety, privacy or trust." Guidehealth uses AI to help health plans and health systems connect patients with care programs and support nurses in delivering more effective care management. "As AI becomes more embedded in health care, organizations must be able to demonstrate that these tools are governed with the same rigor as other critical aspects of care," said Michael Gleeson, Chief Growth and Technology Officer at Guidehealth. "URAC's accreditation ensures that our approach prioritizes strong oversight, patient safety and responsible implementation." RediMinds applies AI to support the work of its Center for Independent Dispute Resolution. Madhu Reddiboina, Founder and CEO of RediMinds, said, "One of the most valuable outcomes of the accreditation was that it pushed us to look beyond the technology itself and examine how people use AI day to day. We strengthened employee training around 'shadow AI', clarified what information employees can and cannot enter into public AI tools, and expanded disclosures across our processes. That practical work is helping us stay proactive as AI continues to evolve, while reinforcing the trust, transparency and governance that responsible AI demands." URAC's Health Care AI Accreditation assesses how organizations manage AI throughout its lifecycle, including implementation, monitoring, risk management and continuous improvement. To learn more about URAC's Health Care AI Accreditation, visit https://www.urac.org/accreditation-cert/healthcareai/ About URAC For 35 years, URAC has served as an independent nonprofit organization dedicated to advancing health care quality. We partner with experts and organizations across the health care landscape to develop rigorous, evidence-based accreditation programs. From health equity to telehealth and AI, in pharmacies, health plans and other health care entities, URAC accreditation ensures that organizations meet high benchmarks across the industry. URAC is proud to have earned Modern Healthcare's Best in Business Award in 2024 and 2025. URAC accreditation is more than a seal of approval; it signals to patients, partners and stakeholders that an organization is committed to quality, trust and accountability in health care. Media Contact Laura A. Wood Director, Marketing, Communications and Workplace Mental Health 202-326-3968 [email protected] SOURCE URAC

Healthcare Industry Today
Jun 8th, 2026
Guidehealth founder and CEO Sanjay Doddamani, MD, named a Modern Healthcare 50 Most Influential Clinical executive.

Guidehealth founder and CEO Sanjay Doddamani, MD, named a Modern Healthcare 50 Most Influential Clinical executive. Recognition honors physician leader advancing value-based care, population health, and AI-enabled healthcare transformation DALLAS, TX, UNITED STATES, June 8, 2026 /EINPresswire.com/ - Modern Healthcare has named the Guidehealth founder and CEO to its prestigious "50 Most Influential Clinical Executives" list, honoring licensed clinicians whose leadership is helping define the future of healthcare. Over the last two decades, Doddamani has helped shape some of healthcare's most important transitions: from fee-for-service to value-based care, from episodic treatment to longitudinal population health management, and now from fragmented operations to AI-enabled healthcare delivery. A practicing cardiologist, physician executive and former senior advisor at the Center for Medicare and Medicaid Innovation (CMMI), Doddamani has spent his career working to make healthcare more accessible, affordable and sustainable. From leading value-based care initiatives at Geisinger to advising federal innovation programs - and helping to build Guidehealth into one of the nation's fastest-growing healthcare enablement organizations - he has consistently focused on improving patient outcomes while strengthening the systems that support them. Fellow honoree and former Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), and current CEO of Optum, Dr. Patrick Conway said, "Sanjay has been a physician executive leader for many years who has demonstrated innovation and impact across roles and settings in value-based care." "From the time Sanjay arrived at Geisinger, he wanted to think differently about how we care for not just individual patients but the larger population of patients," recalled former Geisinger Chief Nursing Executive Janet Tomcavage. "He challenged the norm and pushed the envelope. His approach to surrounding not only himself but the patient with a team of clinicians, advanced practitioners, RN case managers, pharmacists and community health workers, set the stage to think differently about care in the home." Today, that same philosophy drives Guidehealth, which supports nearly one million lives through technology-enabled value-based care, patient engagement, care management, and benefits administration programs. The company partners with health systems, physician organizations, clinically integrated networks, health plans, and employers to improve quality performance, strengthen care coordination, and deliver measurable clinical and financial outcomes at scale. "Dr. Sanjay Doddamani is one of the rare healthcare leaders who combines clinical credibility, operational discipline, and bold innovation to pursue his passion of making great healthcare affordable for all," said Joon S. Lee, MD, CEO of Emory Healthcare. "His work at Guidehealth is redefining how health systems and payers work to make care more accessible, more affordable, and more accountable." The recognition comes amid growing demand for clinically governed AI infrastructure and scalable approaches to longitudinal patient engagement. Under Doddamani's leadership, Guidehealth has expanded partnerships with provider organizations nationwide, earned the DiMe Seal for its RoseConnect conversational AI platform, achieved URAC accreditation in utilization management, been selected to participate in the CMS ACCESS Model, and was recently named to Forbes' list of America's Best Startup Employers for 2026. "I am grateful to my family, my colleagues and everyone I've worked with that shaped my values and my thinking over so many years," said Doddamani. "This recognition reflects our work serving patients across a variety of healthcare organizations to proactively build a more sustainable and empathic healthcare system at a time when the industry is facing enormous pressure around workforce capacity, affordability and flat health outcomes." About Guidehealth Guidehealth is dedicated to making great healthcare affordable for all. The company partners with health systems, payers, and employers to bring scale and predictable performance to value-based care and benefits administration across all lines of business. Led by physicians, Guidehealth combines advanced clinical intelligence, AI-enabled engagement, and remotely embedded Healthguides(TM) to help organizations improve quality, strengthen patient relationships, reduce costs, and achieve better outcomes. Through its Brain-Voice-Touch platform, Guidehealth delivers scalable, human-centered healthcare solutions that make care more accessible, more proactive, and more effective for the nearly one million lives it supports nationwide. Legal Disclaimer: EIN Presswire provides this news content "as is" without warranty of any kind. Healthcareindustrytoday do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.

IT桔子
Aug 14th, 2025
Guidehealth Secures $10M Strategic Investment

Guidehealth, an AI care solutions provider, has secured a $10 million strategic investment led by Memorial Hermann Health System. The funding will accelerate the company's next phase of development, focusing on transforming patient care models, advancing disease prevention, and expanding access to high-quality, value-driven healthcare services.

Moneylife
Aug 13th, 2025
Nifty, Sensex Put in an Oversold Bounce - Wednesday Market Report

Firstsource Solutions (+0.05%) partnered with Guidehealth to accelerate AI-enabled, value-based care innovation for health plans.

Modern Healthcare
Jun 10th, 2025
Emory Healthcare invests in value-based care startup

Guidehealth has developed a platform that connects health systems with AI tools to help providers engage in risk-based payment models.