Manager – Retrieval Operations

Reveleer

. Lead day-to-day execution of Reveleer’s retrieval program for a major customer launch covering approximately 500,000 chases beginning with the October 2026 go-live .

Posted 9/17/2026full-timeRemote • United StatesMid-LevelSenior💰 $60,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing high-volume retrieval programs within healthcare operations, with a strong focus on risk adjustment and HEDIS workflows. Proficient in data analysis and performance monitoring, leveraging AI-enabled tools to enhance operational efficiency.

Highest-signal resume keywords

Healthcare Operations ManagementRisk Adjustment ExpertiseHEDIS Program ManagementTeam Leadership and CoachingData Analysis with Excel, Python, or SQL

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Healthcare OperationsChart RetrievalRisk AdjustmentHEDIS WorkflowsData AnalysisCapacity ForecastingPerformance ManagementSLA ManagementAI-Enabled ToolsStandard Operating Procedures

Soft Skills

Analytical SkillsCommunication SkillsMulti-Priority ManagementProblem-SolvingCollaboration

Tools & Technologies

ExcelPythonSQLAI-Enabled Outreach Tools

Industry Keywords

Medicare AdvantageACA Health PlanBusiness Process OutsourcingShared Services ModelOffshore Team Coordination

Tech Stack

Tools & technologies

PythonSQL

About the role

Key responsibilities & impact

Lead day-to-day execution of Reveleer’s retrieval program for a major customer launch covering approximately 500,000 chases beginning with the October 2026 go-live
Own daily and weekly chase queue execution, monitoring retrieval rate, pend rate, and AID ownership across roughly one million annual chases
Manage chase-to-AID assignments and adjust workflows as volume and provider mix change
Resolve aged and at-risk chases and escalate systemic retrieval barriers
Oversee performance of AI-enabled platform voice agents supporting retrieval outreach
Monitor agent-to-human conversion and outcome metrics and identify tuning opportunities
Maintain PSR staffing models and capacity forecasts based on volume, seasonality, and agent-enabled throughput
Partner with the India retrieval team to align onshore and offshore capacity
Serve as the day-to-day operational point of contact for the retrieval relationship
Partner with Onboarding & Data Management on data quality and provider-matching issues
Coordinate provider- and member-facing retrieval escalations with Customer Support
Produce the Chase Status Underlying Report analysis and maintain retrieval, pend, and escalation tracking
Build weekly and monthly scorecards for Reveleer and customer leadership
Contribute performance narratives and data to quarterly business review materials
Lead root-cause analysis of retrieval shortfalls, provider access issues, and agent performance gaps
Establish escalation paths across Retrieval Services, Clinical Operations, and Engineering
Drive corrective action plans to closure and confirm sustained improvement
Identify opportunities to expand AI agent-enabled retrieval to additional chase types or provider segments
Document and refine standard operating procedures for the blended agent and PSR retrieval model
Share launch lessons learned with peers supporting other RISK, HEDIS, and IVA programs

Requirements

What you’ll need

5+ years of experience in healthcare operations, chart retrieval, risk adjustment, or HEDIS/quality program management
2+ years of experience directly managing a team of individual contributors, including performance management and coaching
Experience managing large-scale, high-volume retrieval or outreach programs against defined SLAs
Working knowledge of risk adjustment and HEDIS retrieval workflows, including chase, AID, and pend code concepts
Comfort working with AI-enabled or automated outreach tools, including monitoring performance and identifying tuning opportunities
Strong analytical skills, including proficiency in Excel; experience with Python or SQL for data analysis is a plus
Demonstrated ability to build and maintain staffing and capacity forecasting models
Excellent written and verbal communication skills, with experience presenting performance data to customers or senior leadership
Ability to manage multiple priorities in a fast-paced, deadline-driven environment
Direct experience with Medicare Advantage or ACA health plan customer (preferred)
Experience in a business process outsourcing (BPO) or shared services operating model, including offshore team coordination (preferred)

Benefits

Comp & perks

Competitive salary
Medical, Dental and Vision benefits
401k with Employer Match
Generous PTO plan