[Hiring] Client Business Manager @Guidehealth

Role Description

The Client Business Manager at Guidehealth supports client success by assisting with client onboarding, operational support, and service delivery. In this role, you’ll work closely with clients, health plans, and internal teams to ensure seamless operations, build strong relationships, and contribute to Guidehealth’s mission of advancing value-based healthcare.

• Working in a fully remote environment, engaging virtually with clients, health plans, and internal teams.
• Owning client onboarding, ongoing operational support, and service delivery for assigned clients, from go live through steady state.
• Building and maintaining positive relationships with client administrators, network providers, and management teams to support satisfaction and retention.
• Managing the operational delivery of delegated services for assigned clients, including Eligibility, UM (non-clinical), PHM, Claims, Quality, CX, and Credentialing/Provider Relations.
• Ensuring regulatory and contract compliance across assigned clients.
• Preparing and delivering monthly delegated services report-outs and quarterly executive review materials.
• Tracking, analyzing, and reporting on operational data and performance metrics on a monthly cadence.
• Owning eligibility, capitation, and reconciliation processes for assigned clients.
• Contributing to new client implementations, scope expansions, and cross-client initiatives.
• Tracking SLA performance against contract requirements for every assigned client.
• Leading client operational meetings and participating in UM committees, JOCs, and monthly close meetings for assigned clients.
• Conducting regular client check-ins, satisfaction reviews, and quarterly executive business reviews.
• Serving as the escalation owner for claim denials, authorization issues, eligibility questions, provider complaints, and other client operational issues.
• Supporting renewal cycles, including SLA restructuring and PMPM negotiation input.
• Representing Guidehealth at BCBSIL summer and winter forums.
• Maintaining accurate client contract documentation, DORs, SOWs, and SLA schedules for the assigned portfolio.
• Contributing to team-wide operational improvements.
• Managing daily work using multiple systems, including EMR systems, payer portals, and Microsoft 365.
• Collaborating with internal teams to deliver integrated services and a consistent client experience.

Qualifications

• Bachelor’s degree preferred; Associate degree or equivalent experience considered.
• 3+ years of experience in healthcare operations, managed care, IPA operations, health plan operations, or a related field.
• Experience owning or contributing meaningfully to client facing operational work.
• Demonstrated verbal and written communication skills.
• Strong organizational skills and the ability to track multiple workstreams.
• Strong analytical and problem solving skills.
• Ability to manage a portfolio of clients and competing priorities independently.
• Proficiency in Microsoft 365 and ability to learn multiple systems.
• Driver’s license and reliable transportation (25% travel in Chicago area required).

Requirements

• Direct experience with delegated services (UM, Claims, Credentialing, Eligibility, PHM, Quality, or CX) in an IPA, health plan, or delegated entity setting.
• Familiarity with value based care contracts (shared savings, full risk, capitation) and PMPM based service arrangements.
• Experience with SLA tracking, contract compliance reporting, and health plan or NCQA/URAC audit preparation.
• Familiarity with claims workflows, eligibility files (834), capitation reconciliation, and payer portals.
• Experience presenting operational and executive level reporting to client leadership.
• Basic knowledge of EMR systems and healthcare data platforms.

Benefits

• Work from Home: Guidehealth is a fully remote company.
• Keep Health a Priority: Comprehensive Medical, Dental, and Vision plans.
• Plan for the Future: 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: Life and Disability insurance provided.
• Feel Supported When You Need It Most: Employee Assistance Program (EAP) available.
• Take Time for Yourself: Paid time off plans offered.
• Support Your New Family: Paid parental leave available.
• Learn and Grow: Resources dedicated to your learning and development.