Provider Escalation & Education - Senior Manager

Job Description

A bit about this role: 

The Provider Escalation & Education (Prov Esc/Edu) team is dedicated to maintaining strong operational relationships with our Critical Provider Organizations (CPOs) while focused on building partnerships that reduce frustration through efficient issue management and proactive solutions. Our mission is to minimize unnecessary friction and demonstrate true partnership with our provider partners, solidifying Devoted as the health plan of choice and the preferred partner for provider organizations.

In this role, the senior manager will lead the development of a new team focused on managing group escalations and centralizing issue intake by building efficient processes and effective tooling. They build out our capabilities to respond to issues, ensuring that provider concerns are addressed promptly and effectively, thereby fostering stronger partnerships and trust with our Critical Provider Organizations (CPOs). A key responsibility will be engaging directly with our critical provider groups during issue escalations. By meeting face-to-face with these providers, the manager will work to build trust and resolve issues effectively.

Additionally, by driving upstream operational initiatives, the manager will identify key pain points and collaborate with cross-functional teams to charter and implement innovative program solutions that mitigate future escalations and improve overall operational performance. This role is pivotal in fostering a culture of proactive problem-solving and continuous improvement within the new team.

Your Responsibilities and Impact will include:

• Drive Issue Resolution Excellence: Manage issue resolution, ensuring timely and effective responses to provider concerns while enhancing satisfaction and trust.

• Lead the Charge in Issue Centralization: Spearhead efforts to build a new process to centralize the centralization of provider issue intake, to improve efficiency across the organization.

• Champion Upstream Innovations: Lead initiatives to identify, charter, and execute upstream operational improvements, proactively tackling challenges before they escalate and transforming our operational landscape.

• Build Insight-Driven Tooling: Develop and implement tools to accelerate and scale our ability to deliver actionable insights, enhancing data visibility and empowering our ability to make informed decisions.

• Be a Change Maker: This is an opportunity to make a real impact, ensuring our provider partners feel valued and respected while reinforcing our mission to minimize frustration and strengthen relationships.

• Foster Strong Provider Relationships: Meet with providers to resolve escalations and deliver proactive performance insights, actively engaging to understand their needs and challenges.

Required skills and experience:

• Strategic analytical horsepower: Proven ability to leverage complex data sets to inform strategic initiatives and team development, while articulating compelling, data-driven narratives that drive organizational vision and ensure alignment.

• Operations minded: define an endpoint and formulate & execute against a plan for getting there, with quantifiable mile markers along the way.

• Relationship builder: expert at building relationships with a broad range of internal and external stakeholders (provider groups).

• Communication skills: conversational agility expertise demonstrated by the ability to reframe, refocus, and redirect conversations to realize accretive partnerships and desired outcomes.  Additionally, this individual needs to be able to condense complex concepts into simple explanations with clear and concise calls to action.

• Organization skills: super organized with an eye for detail and the ability to understand and document what matters. Staying organized is a critical component of being able to pivot between going deep into the details and stepping back to see themes or levers that inform strategy.

• Writing Skills: Strong writing ability to craft thoughtful, clear, and persuasive communications to providers, ensuring messages are data-driven and tailored to meet specific needs and contexts.

Desired skills and experience:

• Proven ability to thrive in a fast-paced startup environment

• Capacity for high throughput, while working both autonomously and collaboratively with others

• Experience with leveraging analytics