Teams at Harbor Health

Own product definition and evolution of health plan benefits, translate benefit design into system requirements, collaborate with engineering, vendors, compliance, and operations to build claims adjudication, eligibility, and benefits infrastructure that delivers member-friendly cost experiences.

Lead a team handling member and provider grievances, appeals, and escalations. Ensure compliant, documented investigations and resolutions, develop SOPs and QA programs, liaise with Legal/Compliance/Operations, report trends to leadership, and coach staff to drive continuous improvement.

Serve as the field-based primary contact for in-network provider groups to build relationships, resolve claims/authorization/credentialing issues, improve member access and network performance, support onboarding and value-based initiatives, and collaborate cross-functionally to reduce provider friction and drive measurable operational improvements.