Manager - Healthcare Services

To resolve internal escalations of non-approved pre-authorization cases on time and restore member confidence through clear communication and coordinated clinical review. End-to-End Escalation & Recovery Case Management • Handle internal escalations of non-approved pre-authorization cases. • Coordinate clinical review of escalated cases.

• Coordinate with Medical, Operations and Customer Care to resolve cases on time. • Track open escalations to control the case backlog. Member Recovery & Service Excellence • Conduct recovery reviews for predefined eligible cases. • Contact members to understand and address their concerns. • Communicate case outcomes to members clearly.