Regional Network Manager
Core
Drive process improvements, quality, and efficiency in high-volume medical operations (Medical Review, Appeals, Claims) by analyzing workflows, implementing new systems, and leading training.
Role type
Senior IC Process Improvement Manager
Builds
Operational workflows, reporting systems, and process documentation for healthcare claims and appeals
Domain
Healthcare / Insurance / Claims Processing
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure
Required skills
Process improvement, workflow analysis, system implementation, training delivery, workload reporting, data analysis, project management
Preferred skills
RN certification, Certified Project Manager, Certified Professional Coder, Behavioral Health license, high-volume operations experience, advanced analytics
Technologies
Production systems, reporting tools, workflow management platforms
Responsibilities
Represent the department on process improvement teams and special projects; Lead the annual review and revision of procedures; Train associates on new processes and procedures; Analyze monthly workload reports to ensure timeliness and backlog goals; Identify areas of concern and implement corrective plans; Provide specialized input on reports to management regarding system changes.
Seniority
Senior, hands-on IC