Client Business Manager

Job not on LinkedIn

🔥 1 minute ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $65k - $70k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 11%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Guide Healthcare

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

🏥 Healthcare

🎯 Recruiter

Healthcare Insurance • Healthcare • Recruitment

Guide Healthcare is leading a movement where creativity delivers positive change in the healthcare sector. The company specializes in allied health service provision and healthcare recruitment, focusing on the support and treatment of older adults. With a commitment to adding value to their clients, partners, and teams, Guide Healthcare aims to do things differently in the industry.

📋 Description

• Support client success through client onboarding, operational support, and service delivery • Engage virtually with clients, health plans, and internal teams • Own onboarding, ongoing operational support, and service delivery from go-live through steady state • Build and maintain relationships with client administrators, network providers, and management teams • Manage delegated-service delivery across Eligibility, non-clinical UM, PHM, Claims, Quality, CX, and Credentialing/Provider Relations • Serve as primary accountability owner for delegated-function performance • Ensure regulatory and contract compliance • Prepare monthly delegated-services report-outs and quarterly executive review materials • Support URAC, HCAPA, and health plan pre-delegation audit preparation • Track, analyze, and report operational data and performance metrics monthly • Identify trends and drive issues to resolution across internal functions • Own eligibility, capitation, and reconciliation processes and resolve discrepancies with Finance and Eligibility • Contribute to new-client implementations, scope expansions, platform transitions, network builds, and accreditation renewals • Track SLA performance against contract requirements and drive remediation • Lead client operational meetings and participate in UM committees, JOCs, and monthly close meetings • Conduct client check-ins, satisfaction reviews, and quarterly executive business reviews • Track CSAT and NPS against annual targets • Own escalations involving claim denials, authorization issues, eligibility questions, provider complaints, roster discrepancies, payment issues, and other operational issues • Support renewals, including SLA restructuring, PMPM negotiation input, scope expansion proposals, and BAA updates • Represent Guidehealth at BCBSIL forums and translate regulatory and program changes into operational actions • Maintain client contract documentation, DORs, SOWs, and SLA schedules • Contribute to operational-improvement initiatives such as paper-claims reduction, EFT/ERA adoption, OON reduction, and denial workthrough • Use EMR systems, payer portals, Guidehealth applications, and Microsoft 365 • Collaborate with internal teams to deliver integrated services and a consistent client experience

🎯 Requirements

• Associate degree or equivalent experience considered • 3+ years of experience in healthcare operations, managed care, IPA operations, health plan operations, or related field • Experience owning or meaningfully contributing to client-facing operational work with accountability for outcomes • Demonstrated verbal and written communication skills • Ability to listen actively, run structured client meetings, and communicate clearly with clients, health plan partners, and cross-functional teams • Strong organizational skills and ability to track multiple workstreams, deadlines, and deliverables • Strong analytical and problem-solving skills • Ability to manage a client portfolio and competing priorities independently in a fast-paced environment • Proficiency in Microsoft 365, including Excel, Word, PowerPoint, Outlook, and Teams • Ability to learn multiple systems • Driver’s license and reliable transportation • Ability to travel 25% in the Chicago area • Direct delegated-services experience preferred, including UM, Claims, Credentialing, Eligibility, PHM, Quality, or CX • Familiarity with value-based care contracts, shared savings, full risk, capitation, and PMPM service arrangements preferred • Experience with SLA tracking, contract compliance reporting, and health plan or NCQA/URAC audit preparation preferred • Familiarity with claims workflows, 834 eligibility files, capitation reconciliation, and payer portals preferred • Experience presenting operational and executive-level reporting to client leadership preferred • Basic knowledge of EMR systems and healthcare data platforms preferred • Employees must provide an internet connection with at least 100 Mbps download and 10 Mbps upload • Employees must be accessible during stated working hours and participate in virtual meetings with cameras on • Must follow security policies and procedures protecting PHI, PII, and Guidehealth intellectual property

🏖️ Benefits

• Fully remote work arrangement • Necessary work equipment provided at no charge • Medical, dental, and vision plans • 401(k) plan with a 3% employer match to employee's 6% contribution • Life and disability insurance • Voluntary life insurance options • Employee Assistance Program (EAP) • Paid time off plans • Paid parental leave • Learning and development resources • Flexible work-from-home arrangement • Full-time employees working 30+ hours per week eligible for comprehensive benefits