Supervisor/Team Lead, Content Ideation and Configuration

What You'll Do

In this role, you will have the opportunity to:

• Lead a team of associates responsible for identifying, investigating, and validating payment and revenue integrity opportunities while ensuring adherence to quality standards and service level agreements.
• Develop employee performance through coaching, training, mentorship, performance management, and career development initiatives.
• Manage departmental priorities, workloads, and resources to achieve operational goals, recovery targets, and productivity objectives.
• Oversee offshore vendor relationships, including work allocation, training coordination, performance monitoring, and issue resolution.
• Drive continuous process improvement by identifying operational trends, addressing challenges, and implementing best practices that enhance efficiency and results.
• Partner with senior leadership to establish and execute short- and long-term production strategies that support organizational objectives.
• Ensure compliance with CMS, NAIC, state Coordination of Benefits (COB) guidelines, HIPAA requirements, and client-specific expectations.
• Resolve client concerns and operational issues by providing effective leadership, sound judgment, and customer-focused solutions.

What You Will Bring

Required Qualifications

• High school diploma or equivalent.
• Minimum of five (5) years of experience in healthcare operations, insurance operations, coordination of benefits (COB), Medicare Secondary Payer (MSP), ESRD Premium Restoration, claims processing, or a related environment.
• Minimum of two (2) years of supervisory, management, or team leadership experience.
• Demonstrated ability to lead teams, manage performance, and achieve operational goals.
• Strong organizational, analytical, decision-making, and problem-solving skills.
• Proven ability to manage multiple priorities and meet established timelines in a fast-paced environment.
• Client-focused mindset with a track record of delivering results and building strong business relationships.
• Proficiency with Microsoft Office applications, including Microsoft Excel.
• Required licensure, certifications, and/or professional credentials, as applicable.
• Ability to maintain confidentiality and comply with HIPAA requirements.

Preferred Qualifications

• Experience leading healthcare payment integrity, revenue integrity, coordination of benefits, or claims operations teams.
• Knowledge of CMS regulations, NAIC requirements, Medicare Secondary Payer rules, and state COB guidelines.
• Experience managing offshore or vendor-supported operations.
• Experience developing operational metrics, key performance indicators (KPIs), and performance management programs.
• Demonstrated success implementing process improvements and driving operational efficiency.
• Additional certifications related to healthcare operations, leadership, project management, or insurance administration.

Compensation

Actual compensation is based on experience, skills, education, work location, and internal equity. This position may also be eligible for incentive compensation and the comprehensive benefits outlined in the My Total Value section.

In addition, this position is eligible for health insurance, a 401(k) plan, and bonus opportunities.

Additional Information

This position operates with limited supervision and serves as a key contributor in the development, implementation, and maintenance of departmental policies, procedures, and operational standards. The role has significant influence on departmental performance through leadership, employee development, process improvement, and resource management.

This is a people leadership role with responsibility for hiring, coaching, performance management, training, disciplinary actions, work assignment, and coordination of offshore resources.

Due to exposure to Protected Health Information (PHI), this role is designated as a High Risk Role and requires strict adherence to HIPAA, privacy, security, and confidentiality standards.

The responsibilities described above are not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with this position. Additional duties may be assigned as business needs require.

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Why Claritev?

Healthcare is complex. We help make it clearer.

At Claritev, you'll do work that matters. Together, we're helping make healthcare more transparent and affordable for all through the power of data, technology, and expertise. We offer meaningful opportunities to grow your career, collaborate with talented colleagues, and make an impact on the clients and communities we serve. If you're looking for purpose, growth, and a team that succeeds together, you'll find it here.

What Guides Us

At Claritev, innovation, agility, and a focus on results drive our success. We embrace bold thinking, work as one team, take ownership, and strive for excellence in everything we do - creating meaningful impact for our clients, communities, and each other.