Manager -Executive Escalations
Core
Lead and oversee the resolution of complex, sensitive, and high-profile medical and dental escalations for federal employees and retirees, ensuring reputationally sound outcomes and systemic improvements.
Role type
Manager, Executive Escalations
Builds
Resolution of high-risk member escalations and process improvements for federal health benefits
Domain
US Federal Employee Health Benefits / Claims Adjudication
Deliverable
client delivery | dashboards & analysis
Required skills
People leadership and team management, Executive escalation oversight, Investigation and root cause analysis, Cross-functional partnership, Reporting and trend analysis, Knowledge of medical terminology and claims adjudication, Advanced analytical and critical thinking, Executive-level communication, Judgment in managing reputational risk
Preferred skills
Lean management principles, Process improvement initiatives
Technologies
Excel, PowerPoint, Power BI
Responsibilities
Lead, coach, and develop a team of Executive Escalation Specialists; Provide oversight on sensitive, complex, or high-risk escalations including OPM grievances; Establish and maintain investigative standards for root cause analysis; Partner with operations, pharmacy, dental, and vendors to resolve escalations; Oversee tracking, reporting, and analysis of executive-level escalations and trends
Seniority
Manager, hands-on IC with team leadership