Senior Lead Carrier Engagement
Share
Job Location:
Monthly Salary:
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Position Overview
The Senior Lead of Carrier Engagementis responsible forthe endtoend performance satisfaction and operational excellence of the companys carrier network. This role develops manages and strengthens strategic carrier relationships while ensuring accuracy compliance service quality and a consistently positivecarrierexperience. Acting as the primary liaison between carriers and internal teams the Senior Lead drives alignment transparency and continuous improvement across communication operations payment processes andpartnership programs.
This position oversees key functions including payment operations quality assurance carrier engagement and experience management. The Senior Lead initiates andmaintainssavings and performanceimprovement initiatives with carrier partnersidentifyingopportunities for operational enhancements and friction reduction. The role also provides analytical insights and performance reporting during internal and external business reviewsrepresentingthe organization in client and carrierfacing discussions.
Additionally the Senior Lead collaborates closely with IT andcrossfunctionalteams to enhance tools processes and technologyimpactingcarriers and the carrier engagement team. By championing operational integrity strengthening partnerships and driving datainformed improvements this role ensures a seamless reliable and transparent endtoend experience for carriers partners and internal stakeholders while supporting organizational growth.
Responsibilities
Attendmonthly Business Review meetings with clients providing detailed and analytical data insights as it relates to carrier engagement.
Attend monthly Carrier meetingsproviding referral findings and leading data-driven discussion
Facilitate feedback loops to understand carrier needs and drive continuous improvement
Hands-on delivery of the carrier experience visionstandardsand service models
Leadinitiatives that strengthen trust transparency and partnership with carriers
Identifyperformance gaps and lead crossfunctional improvement plans
Manageescalations and ensuretimelyresolution of carrier issues
Champion aconsistent highquality experience across all carrierand clienttouchpoints
Serve as an executive liaison for carrier and client relationships focusing on serviceperformanceand partnership
Develop team capabilities in communication analytics relationship management and problem-solving
Qualifications
Bachelors degree inbusiness operations or related field; advanced degree preferred
Payor/Carrier experience isrequired
5- 10 years of experience in paymentintegrityoperations financial operations or quality management
Experience managingthe payment integrity operations process workflowpatternsandcomplex operational programs
Experience managing external partners or vendors preferred
Strong analytical problemsolving and processimprovement skills
Skills & Competencies
Strong relationshipbuilding and communication skills
Ability to navigate understand and explain claims and billing data
Some combination of coding/medical records or carrier payment integrity work
Analytical mindset with the ability to interpretlargedatasetsand drive decisions
Excellent organizational and project management abilities
Ability to navigate complex issues with diplomacy and accountability
Success Indicators
Carriers consistently meet or exceed performance expectations
Strong collaborative relationships withcarriersand internal teams
Reduced escalations and improved issueresolution timelines
Clear consistent communication and documentation across all carrier interactions
Measurable improvements in carrier satisfaction and operational efficiency
Who isSmartLightAnalytics
SmartLightAnalytics was formed by a group of industry insiders who wanted to make a meaningful impact on the rising cost of healthcare. With this end in mindSmartLightworks for self-funded employers to reduce wasteful spending in their healthcare plan through our proprietary data analysis. Our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes.
Required Experience:
Senior IC
Key Skills
- Business Development
- Employee Orientation
- Public Health
- Account Management
- VersionOne
- Conflict Management
- Project Management
- Relationship Management
- Team Management
- Customer relationship management
- Human Resources
- Public Speaking
About Company
Harness the power of your healthcare data Solutions to lower healthcare costs without interrupting benefits Learn More DATA LEADS THE WAY SmartLight Analytics provides independent, ongoing monitoring of your employee healthcare claims data to find and remove wasteful spend from your h ... View more
