Supervisor, Provider Disputes

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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.


SCOPE OF ROLE

The Provider Disputes Team Supervisor is responsible for providing exceptional & dedicated support to the Provider Disputes  Team, while demonstrating & incorporating the Bright values into day to day operations.

ROLE RESPONSIBILITIES

The Provider Disputes Team Supervisor job description is intended to point out major responsibilities within the role, but it is not limited to these items.

  • Monitors all incoming Provider Dispute channels(fax, phone, email), and routes work to team members; ensures that cases are completed within turnaround times
  • Oversees Provider Dispute Team in completing casework, including performance improvement, coaching and development in accordance with Bright standards
  • Participates in and/or leads audits, partners with analytics, compliance to analyze and finalize data sets, be presenter at audit, responder to inquiries
  • Develop and deliver needed training on systems and processes, perform Desk Level Procedures (DLP) development and maintenance, lead regular team meetings and 1:1s
  • Analyze and report daily/weekly/monthly performance metrics and issue trends
  • Other duties and responsibilities as assigned

SUPERVISORY RESPONSIBILITIES

This position has supervisory responsibilities.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • High School diploma or GED required; Bachelor’s degree preferred.
  • Five (5) or more years of experience in Health Plan Appeals & Grievances, Provider Disputes or Customer Service required Two + years of leadership experience preferred
  • Call monitoring and QA mentoring experience preferred but not required
  • Experience with Performance Improvement Plans or similar required
  • Experience with classroom and/or individual training sessions required

PROFESSIONAL COMPETENCIES

  • Strong communication skills, both verbal and written
  • Organized and able to prioritize work to meet deadlines
  • Works independently with little supervision
  • Able to thrive in an often-chaotic environment
  • Understands regulatory compliance within the healthcare industry
  • Able to work independently with little supervision
  • Able to thrive in an often-chaotic environment

WORK ENVIRONMENT

  • Most work responsibilities are performed in an open office setting, carrying out detailed work sitting or standing at a desk/table and working on the computer. Some travel may be required. (may be altered during pandemic)
  • Live by the Bright values to maintain a strong, collaborative culture

 

We’re Making Healthcare Right. Together.

We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:

 

Focusing on Consumers
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.

 

Building on Alignment
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.

 

Powered by Technology

We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.

 

          

 

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

 


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Candidate Location Eligibility:
Austin, TX

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