Senior Director, Escalated Provider Issue Resolution
Core
Build and scale the operating model for escalated provider issue resolution, leading a multi-disciplinary team to handle high-complexity escalations, root-cause remediation, and provider service governance.
Role type
Senior Director, operational leadership
Builds
Scalable operating models, governance routines, and cross-functional resolution pathways for provider issues
Domain
Healthcare insurance / Payer operations
Required skills
Healthcare operations leadership, complex issue resolution, operating model design, cross-functional partnership, root-cause analysis, change management, executive reporting
Preferred skills
Provider service transformation, strategic provider relationship management, workflow management tools (Jira, Salesforce, ServiceNow), data analytics (SQL, Excel)
Responsibilities
Lead and develop a multi-disciplinary provider issue resolution organization; Build a scalable operating model for escalated provider issues; Oversee resolution of high-impact provider issues; Partner with leaders across Claims, Network, Utilization Management, and Analytics; Oversee root-cause remediation; Create executive-ready reporting on provider issue trends; Serve as a senior escalation leader for urgent, complex, or high-profile provider issues
Seniority
Senior Director, strategic leadership
