[Hiring] Manager - Executive Escalations @GEHA Health

Role Description

The Manager, Executive Escalations reports to the VP – Product Development and leads and oversees G.E.H.A.’s Executive Escalations function, ensuring the timely, accurate, and reputationally sound resolution of the organization’s most complex, sensitive, and high-profile medical and dental escalations. This role is responsible for handling executive escalations and managing a team of Executive Escalation Specialists, setting standards for investigative rigor, communication quality, and stakeholder engagement, and serving as a key liaison between cross-functional partners.

Qualifications

• Bachelor’s degree in a related field required.
• 5-8 years of experience in a medical and/or dental health plan environment.
• Minimum of 3 years of people management experience, preferably leading teams handling complex escalations or investigations.
• Minimum of 2 years of demonstrated experience in implementing Lean management principles and executing process improvement initiatives.
• Extensive knowledge of medical terminology, claims adjudication processes, and regulatory considerations.
• Demonstrated ability to lead, coach, and develop high-performing teams.
• Advanced analytical, investigative, and critical-thinking skills.
• Exceptional written and verbal communication skills, including executive-level correspondence.
• Strong judgment in managing sensitive situations and reputational risk.
• Ability to summarize and present insights using Excel, PowerPoint, and/or Power BI.

Requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
• Latency (ping) response time lower than 80 ms.
• Hotspots, satellite and wireless internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Benefits

• Competitive pay/salary ranges.
• Incentive plan.
• Health/Vision/Dental benefits effective day one.
• 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution.
• Robust employee well-being program.
• Paid Time Off.
• Personal Community Enrichment Time.
• Company-provided Basic Life and AD&D.
• Company-provided Short-Term & Long-Term Disability.
• Tuition Assistance Program.