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Clinical Delivery Manager- Eligibility
Twin Health Raleigh, NC
$86k-108k (estimate)
Full Time 2 Months Ago
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Twin Health is Hiring a Remote Clinical Delivery Manager- Eligibility

Opportunity 

Twin Teammates of the Clinical Delivery Management team make a difference at Twin by playing a critical role in project managing, coordinating and implementing workflows in efficient, effective and streamlined for optimal workflows to support our Clinical Delivery Model across internal work streams and partners in service to our members and their experience. 

Reporting directly to the VP of Clinical Deliver & Licensing, the Clinical Delivery Manager of Eligibility will join the organization at a pivotal time in its growth track to support the business across all conversion enablement activities.

Clinical Delivery Management is a key role within the Clinical Operations department to have end to end oversight over the partner lifecycle and member journey to promote operational excellence. Our department will achieve this by problem solving, translating and liaisoning various operational initiatives on behalf of the Clinical Care Team so they can provide exceptional care to our members on their metabolic healing journey as we support the business in driving member outcomes, growth and economics. 

Key Metrics

  1. Conversion Enablement Support
  2. Coverage Eligibility Operations
  3. Clinical Eligibility Operations
  4. Partner Lifecycle Operational Workflows & Performance
  5. Satisfaction (partner, member, care team) 

Responsibilities 

Working in partnership with VP of Clinical Delivery & Licensing, the Clinical Delivery manager of Eligibility will work on a diverse scope and manage operational initiatives to deliver results​ as it relates to Conversion Enablement Support as it relates to Partner Launch Readiness and Member Eligibility Operations. 

We're looking for a self-starter who can work productively under tight deadlines without compromising attention to detail with specific ability to take initiative and thrive in a semi-structured and dynamic work environment. This role will require a blend of strong skill set to proactively identify and resolve issues, have deep interpersonal skills, an understanding of healthcare operations, and the ability to collaborate across various clinical functions to support the member journey. This role will translate objectives for cross-fx teams and departments and guide execution on the following areas of focus:

Member Eligibility Operations This role is responsible for resolving member eligibility inquiries and working across multiple departments and support day-to-day verification of accurate member eligibility and insurance coverage across multiple payer plans and systems

    • Management and guidance of all Conversion Enablement activities & grievances as Twin prepares for growth and scale 
    • Monitor and navigate coverage eligibility management to provide best service experience to members and to support partner escalation pathways 
    • Monitors Clinical eligibility criteria and adjustments along partner lifecycle to provide best service experience to members and to support partner escalation pathways 
    • Resolves eligibility inquiries and create a process to support cross-functional lessons learned and improvements to impact outcomes
    • Oversees member eligibility operations support & end-to-end journey workflow needs between people, systems and processes. 

Partner Launch Readiness & Process Improvement:

    • This role is also responsible for Partner Launch Readiness Oversight and have good organizational, multi-tasking, and time management skills, with excellent attention to detail
    • Leverages Salesforce as our Source of Truth tool to ensure that all launches have completed our readiness checklist and all workstreams are prepared for launch
    • Product Feature Deployments w/ Impacts to Clinical Workflows
    • Strong collaboration with the Partner Experience Team & Clinical Operations Team & Product Operations to communicate risks and challenges ensuring external factors are alleviated and mitigated for the optimal member experience
    • Participate in special projects and provide ad hoc analytical eligibility support as needed

Qualifications 

  • 5 years experience successfully project managing and implementing experience (processes, people, technology) across a variety of partner types (Health Plans, Payers, Self-Insured Employers - all 3 a plus) 
  • Have knowledge of EDI 270/271 transactions and insurance eligibility verification Have strong work ethic, resourcefulness, and the motivation to succeed
  • Ability to communicate and work across client organizations, engaging on a range of tactical and strategic issues, with senior executives as well as execution teams
  • Have experience working with insurance companies in the healthcare provider industry
  • Exceptionally strong project management skills, with demonstrated organizational skills, high attention to detail and ability to balance between thoughtful planning and timely execution
  • Ability to manage conflicting priorities and thrive in a fast-paced environment working under time constraints to manages all changes that come with a rapidly expanding organization in a high growth environment
  • Proficiency in Excel and have a natural drive for putting order to unstructured information process and Have advanced Excel skills, with the demonstrated ability to write formulas, perform VLOOKUP, pivot tables. Etc and have product experience (ie salesforce)
  • This remote opportunity is available to US based persons. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Compensation and Benefits

The compensation range for this position is $100,000-$120,000 annually. 

In addition, Twin has an ambitious vision to empower people to live healthier and happier lives, and to achieve this purpose, we need the very best people to enhance our cutting-edge technology and medical science, deliver the best possible care, and turn our passion into value for our members, partners and investors. We are committed to delivering an outstanding culture and experience for every Twin employee through a company based on the values of passion, talent, and trust. We offer comprehensive benefits and perks in line with these principles, as well as a high level of flexibility for every Twin

  • A competitive compensation package in line with leading technology companies
  • As a remote friendly company we are committed to providing opportunities for all who join to further build relationships, increase cross-functional collaboration, and celebrate our accomplishments.
  • Opportunity for equity participation 
  • Unlimited vacation with manager approval
  • 16 weeks of 100% paid parental leave for delivering parents; 8 weeks of 100% paid parental leave for non-delivering parents
  • 100% Employer sponsored healthcare, dental, and vision for you, and 80% coverage for your family; Health Savings Account and Flexible Spending Account options
  • 401k retirement savings plan

Job Summary

JOB TYPE

Full Time

SALARY

$86k-108k (estimate)

POST DATE

03/30/2024

EXPIRATION DATE

04/28/2024

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