Manager of Retrieval Operations

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Manager of Retrieval Operations based in the United States.

The Manager of Retrieval Operations leads the day-to-day execution of a large-scale healthcare retrieval program supporting a high-volume customer launch.
The role oversees retrieval workflows, throughput, retrieval rates, pending items, and escalation management across a substantial book of business.
You will lead a blended operating model that combines AI-enabled voice agents with human Patient Support Representatives.
A key focus will be balancing staffing, capacity, automation, and weekly chase volumes to consistently meet service-level expectations.
You will also serve as an operational partner to customers and internal teams, translating performance data into clear action plans.
The position offers an opportunity to improve retrieval efficiency through analytics, process optimization, and intelligent automation.
Success requires strong healthcare operations expertise, people leadership, analytical judgment, and the ability to manage complex programs in a fast-paced environment.

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Accountabilities

• Retrieval execution: Own daily and weekly chase-queue execution, monitoring retrieval rates, pend rates, AID ownership, and overall program performance across a high-volume retrieval operation.

• Workflow management: Manage chase-to-AID assignments and adjust workflows as volumes, provider profiles, and operational requirements evolve.

• Issue resolution: Drive resolution of aged and at-risk chases while escalating systemic retrieval barriers before they impact service-level performance.

• AI-enabled operations: Oversee the performance of AI-powered voice agents used for retrieval outreach, monitoring conversion and outcome metrics and identifying opportunities for workflow or agent optimization.

• Capacity planning: Maintain staffing models and capacity forecasts for Patient Support Representatives, accounting for volume changes, seasonality, and automation-driven productivity gains.

• Team coordination: Partner with offshore retrieval teams to align capacity with weekly intake and recommend staffing adjustments to maintain appropriate service levels.

• Customer partnership: Serve as the day-to-day operational contact for retrieval activities, communicating performance, requirements, risks, and action plans to customer stakeholders.

• Cross-functional collaboration: Work with data management, onboarding, customer support, clinical operations, and engineering teams to address data-quality, provider, member, and production issues.

• Performance reporting: Produce retrieval performance analyses, status reports, scorecards, escalation lists, and customer-facing performance narratives for weekly, monthly, and quarterly reviews.

• Root-cause analysis: Investigate retrieval shortfalls, provider-access challenges, and agent performance gaps, establishing corrective action plans and tracking them through completion.

• Process improvement: Identify opportunities to expand AI-enabled retrieval, refine standard operating procedures, improve operational efficiency, and share lessons learned across related healthcare programs.

Requirements

• Experience: 5+ years of experience in healthcare operations, chart retrieval, risk adjustment, HEDIS, quality programs, or a comparable healthcare operations environment.

• People leadership: At least 2 years of direct experience managing individual contributors, including coaching, performance management, and team development.

• Program management: Demonstrated experience managing large-scale, high-volume retrieval or outreach programs against defined service-level agreements and performance targets.

• Healthcare knowledge: Working knowledge of risk adjustment and HEDIS retrieval workflows, including concepts such as chases, AIDs, and pend codes.

• AI and automation: Comfortable working with AI-enabled or automated outreach technologies, monitoring performance and identifying opportunities for optimization.

• Analytics: Strong analytical capabilities with proficiency in Microsoft Excel; Python or SQL experience for data analysis is a plus.

• Forecasting: Demonstrated ability to develop and maintain staffing, capacity, and volume forecasting models.

• Communication: Excellent written and verbal communication skills, including the ability to present operational performance and recommendations to customers and senior leaders.

• Problem-solving: Strong root-cause analysis and decision-making abilities, with a proactive approach to resolving operational challenges.

• Organization: Ability to manage multiple priorities, deadlines, and stakeholders effectively in a fast-paced environment.

• Preferred experience: Experience supporting Medicare Advantage or ACA health plan customers and/or working within a BPO or shared-services model involving offshore teams is preferred.

• Work style: Comfortable operating independently while collaborating across multiple functions and maintaining a strong focus on service quality and measurable outcomes.

Benefits

• Salary: $60,000–$80,000 per year, with compensation varying based on geographic market, job-related knowledge, skills, and experience.

• Healthcare: Medical, dental, and vision benefits.

• Retirement: 401(k) plan with employer matching.

• Time off: Generous paid time off (PTO) program.

• Work arrangement: Remote position within the United States.

• Additional considerations: New hires are subject to employment verification.

• Workplace: Equal opportunity employment environment with applicable workplace protections.

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How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

 Why Apply Through Jobgether? 

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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