Client Business Manager

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. 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. Under the guidance of senior team members, you’ll utilize data-driven tools to support delegated services and operational processes, helping to achieve measurable outcomes in shared and full-risk arrangements. WHAT YOU’LL BE DOING - 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. Serving as the primary point of accountability for delegated function performance. - Ensuring regulatory and contract compliance across assigned clients. Preparing and delivering monthly delegated services report-outs and quarterly executive review materials.

Supporting URAC, HCAPA, and health plan pre-delegation audit preparation. - Tracking, analyzing, and reporting on operational data and performance metrics on a monthly cadence, using Guidehealth’s applications and reporting tools to identify trends and drive issues to resolution across internal functions. - Owning eligibility, capitation, and reconciliation processes for assigned clients, coordinating with Finance and Eligibility to resolve discrepancies. - Contributing to new client implementations, scope expansions, and cross-client initiatives such as platform transitions, network builds, and accreditation renewals. - Tracking SLA performance against contract requirements for every assigned client. Identifying gaps, driving remediation with internal owners, and reporting status to the client and internal leadership. Maintaining 100% SLA compliance as the standing team goal. - 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. Tracking CSAT and NPS against annual targets. - Serving as the escalation owner for claim denials, authorization issues, eligibility questions, provider complaints, roster discrepancies, payment issues, and other client operational issues, driving resolution with the responsible internal team. - Supporting renewal cycles, including SLA restructuring, PMPM negotiation input, scope expansion proposals, and BAA updates. Tracking assigned clients in the Renewals Master Tracker. - Representing Guidehealth at BCBSIL summer and winter forums and translating regulatory and program changes (risk model, MSA, prior auth submissions) into operational actions for assigned clients.