Senior Manager, Provider Escalation and Education (Healthcare)

TL;DR

Senior Manager, Provider Escalation and Education (Healthcare Operations): Leading the Network Escalations function and designing a next-generation operating model with an accent on AI automation, digital workflows, and provider experience. Focus on building scalable human-in-the-loop systems, managing complex provider relationships, and driving operational excellence through data-driven metrics.

Location: Remote (USA)

Salary: $110,500 - $150,000 /year

Company

hirify.global is an all-in-one healthcare company combining insurance, clinical care, and technology to improve health and well-being for older Americans.

What you will do

• Own the Network Escalations function, ensuring high service levels, quality, and provider satisfaction.
• Lead a team of subject matter experts to resolve complex provider cases and network escalations.
• Design and implement a modern operating model leveraging AI and workflow automation.
• Manage performance via rigorous KPIs, scorecards, and performance dashboards.
• Engage directly with critical provider groups via face-to-face meetings to resolve issues and build trust.
• Collaborate cross-functionally to identify and mitigate upstream drivers of provider issues.

Requirements

• Must be based in the USA.
• 5+ years of leadership experience with a track record of delivering measurable outcomes in complex operational environments.
• Proven ability to drive end-to-end strategic initiatives that improve quality, cost, and operational efficiency.
• Strong expertise in managing teams through metrics and clear accountability.
• Exceptional stakeholder management skills and conversational agility.
• Ability to leverage complex data sets to inform strategic initiatives and organizational vision.

Nice to have

• Experience transforming operations through AI-enabled workflows.
• Proven ability to thrive in a fast-paced startup environment.
• Track record of quickly becoming an expert with unfamiliar tools or systems.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and parental leave program.
• Stock options for all employees and bonus eligibility.
• $100 monthly mobile or internet stipend.
• 401K program.