RCCEM Escalation Manager, Claim Resolution

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Job Title: Escalation Manager, Enhanced Claim Resolution Management

• Models the teams expectations and methodology while supporting and leading the most sensitive engagements.
• Develops and maintains professional and productive ongoing client relationships regarding service related issues.
• Meet with clients and stakeholders weekly, biweekly, monthly, or as necessary to provide senior level escalation engagement updates.
• Leverages strong cross functional partnerships to advocate for changes to service delivery, service offerings and/or product.
• Successfully balances managing individual book of business and supporting others (50/50)
• Develop a comprehensive business case to tell the “impact story” to create a strong sense of client benefit to facilitate effective advocacy
• Lead team initiatives to improve department processes and tools.
• Drives workflow and quality improvements to reduce case inflow and improve client sentiment.
• Utilizes reporting and tools to understand and manage RCCEM book of business.
• Plans and Aligns (Project Management)
• Applies comprehensive project management skills to manage project life cycle to ensure top quality deliverables
• Ensures critical resources are aligned and coordinated across different teams.
• Supports the team in anticipating risk and contingencies as part of the planning process.
• Effectively manages the queue by assigning cases according to skill level, account ownership, and ensuring a balanced workload.
• Provide leadership in escalation and project management.
• Foster team development by enhancing skills in content knowledge, de-escalation strategies, resource utilization, and creating actionable insights.
• Work collaboratively with the Senior Manager on team performance and development opportunities.

• Customer-centric mindset characterized by empathy, collaboration, and advocacy.
• Strong written and verbal communication skills, enabling effective interaction with all organization level and stakeholders.
• Expertise in problem-solving, with the ability to analyze large data sets to identify root causes and trends.
• Proven capability to analyze data, surface trends and insights, and provide actionable recommendations.
• Ability to work independently and as part of a team, knowing when to involve others for effective problem-solving.
• Strong project management skills, including planning and aligning tasks, resources, and timelines.
• Tenacious and accountable, able to navigate complexity and overcome obstacles.
• Proficient in Excel and other business tools (Smartsheets, Google tools, SharePoint, etc.)
• Experience with athenahealth products and services a plus

• 401k matching
• Health insurance
• Flight privileges

Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Our company culture: Our talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.