检索运营负责人
Retrieval Operations Lead
Retrieval Operations Lead
远程办公
关于Reveleer
Reveleer 为健康计划和医疗机构提供一个统一的平台,涵盖风险调整、质量改进、临床智能和成员管理,帮助其应对基于价值的护理的复杂性。全国80多家客户组织信赖该平台,该平台将数据、分析和智能工作流自动化整合到一个受控系统中,旨在支持诊断、质量指标和提交的可追溯文档。凭借监管专业知识和核心的透明人机协作AI,Reveleer 支持致力于提升护理质量、加强文档完整性并保持运营准备能力以自信应对审计的组织。
职位概述:
Retrieval Lead 负责执行Reveleer检索项目的前线工作,涵盖约50万次检索,从2026年10月上线开始。
该职位负责与项目最大的AIDs建立日常关系,分配和重新平衡PSR团队的检索任务,并对新老PSR进行检索流程、标准流程和供应商沟通最佳实践的培训。
该职位是供应商升级的第一响应者,直接解决访问和沟通问题,仅在需要Retrieval Manager介入时才进行升级。
您将负责的工作:
大型AID关系与供应商沟通
- 作为项目最高流量AIDs的主要联系人,与供应商办公室员工保持直接关系。
- 监控大型AIDs的检索表现,并在障碍影响检索完成前主动解决。
- 直接与供应商办公室协调记录请求物流、门户访问和重复检索问题。
任务分配与队列管理
- 根据AID优先级、检索年龄和检索截止日期,在PSR团队中分配和重新平衡每日检索任务。
- 监控个别PSR的工作量,并调整任务以保持队列流动,防止过期检索停滞。
- 与Retrieval Manager合作进行每周容量规划,并在影响吞吐量前标记容量缺口。
PSR培训与发展
- 对新PSR进行检索流程、AID归属、待处理代码处理和平台代理交接的入职和培训。
- 提供持续指导和复习,涵盖检索最佳实践、通话质量和文档记录。
查看英文原文
Retrieval Operations Lead
Remote
About Reveleer
Reveleer delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations navigating the complexity of value-based care. Trusted by 80+ customer organizations nationwide, the platform integrates data, analytics, and intelligent workflow automation into one governed system designed to support traceable documentation across diagnoses, quality measures, and submissions. With regulatory expertise and transparent, human-in-the-loop AI at its core, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.
POSITION OVERVIEW:
The Retrieval Lead drives frontline execution of Reveleer's retrieval program, covering approximately 500,000 chases beginning with the October 2026 go-live.
This role owns the day-to-day relationship with the program's largest AIDs, distributes and rebalances chase work assignments across the PSR team, and trains new and existing PSRs on retrieval workflows, standard processes, and provider outreach best practices.
This role is the first line of response for provider escalations, resolving access and outreach issues directly and escalating only what requires the Retrieval Manager's involvement.
WHAT YOU'LL DO:
Large AID Relationship & Provider Contact
- Serve as the primary point of contact for a program's highest-volume AIDs, maintaining direct relationships with provider office staff.
- Monitor retrieval performance for large AIDs and proactively address barriers before they affect chase completion.
- Coordinate directly with provider offices on record request logistics, portal access, and recurring retrieval issues.
Work Assignment & Queue Management
- Distribute and rebalance daily chase assignments across the PSR team based on AID priority, chase age, and retrieval deadlines.
- Monitor individual PSR workloads and adjust assignments to keep the queue moving and prevent aged chases from stalling.
- Partner with the Retrieval Manager on weekly volume planning and flag capacity gaps before they affect throughput.
PSR Training & Development
- Onboard and train new PSRs on chase workflows, AID ownership, pend code handling, and platform agent hand-offs.
- Deliver ongoing coaching and refreshers on retrieval best practices, call quality, and documentation standards.
- Maintain training materials and job aids, updating them as workflows or systems change.
Provider Escalation Management
- Own first-line resolution of provider escalations related to retrieval outreach, record requests, or access issues.
- Document escalation patterns and root causes and recommend workflow or script changes that reduce recurring issues.
- Escalate unresolved or systemic provider issues to the Retrieval Manager with a clear summary and recommend next step.
Performance Monitoring & Coaching
- Track individual and team-level retrieval rate, pend rate, and productivity against program targets.
- Provide day-to-day feedback and coaching to PSRs based on chase outcomes and call quality.
- Flag underperformance or training gaps to the Retrieval Manager and support corrective action plans.
Process Adherence & Documentation
- Ensure PSR adherence to standard retrieval processes, procedures, and documentation requirements.
- Maintain accurate, current records on AID assignments, escalation status, and chase ownership.
- Support the Retrieval Manager with input on process updates and standard operating procedure revisions.
ABOUT YOU:
- 2+ years of experience in healthcare operations, chart retrieval, risk adjustment, or HEDIS/quality program support.
- 1+ years of experience training, coaching, or leading the daily work of other individual contributors.
- Working knowledge of risk adjustment and HEDIS retrieval workflows, including chase, AID, and pend code concepts.
- Experience managing provider-facing communication, including resolving access or outreach escalations directly.
- Strong organizational skills, with the ability to manage and rebalance work assignments across a team in a fast-paced environment.
- Proficiency in Excel and comfort working within chase or case management systems.
- Excellent written and verbal communication skills, including experience delivering training or coaching.
Preferred
- Direct experience supporting Medicare Advantage or ACA health plan retrieval programs.
- Prior experience formally training or onboarding new hires in a call center or retrieval operations setting.
WHAT YOU’LL RECEIVE:
•Competitive salary
•• Medical, Dental and Vision benefits
•• 401k match
•• Generous PTO plan
- Our compensation reflects the cost of labor across several US geographic markets. Pay is based on several factors including market location and may vary depending on job-related knowledge, skills, and experience.
•Reveleer E-Verifies all new hires.
- Reveleer is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law.
Salary: $21 – $28 / hourOriginally posted on Himalayas