The Supervisor of Escalation leads Harbor Health's complaint resolution function, overseeing a team of resolution specialists responsible for investigating member and provider grievances, appeals, and escalated issues.
Requirements
- 3+ years in healthcare contact center operations with a focus on escalations, grievances, or appeals
- Thorough knowledge of health insurance operations: claims, enrollment/eligibility, billing, prior authorization, and provider networks
- Expert understanding of HIPAA, CMS, TDI, and state/federal managed care compliance standards
- Demonstrated experience with both member and provider services escalation processes
- Ability to interpret EOBs, plan policy language, and contractual agreements to resolve member disputes
- Strong team leadership, coaching, and performance management skills
- Exceptional written and verbal communication; able to manage executive-level and high-stakes member communications
- Proficiency in complaint tracking/CRM systems and reporting tools
Benefits
- Competitive salary and benefits package
- Professional development and growth opportunities as Harbor scales
- A transparent startup culture where your voice shapes how we operate