Behavioral Health Ops & Escalations Lead

Independence Blue Cross, LLC; Philadelphia (Philadelphia County); Hybrid; USD 100,000 - 160,000; Full time

Benefits offered by this job

Hybrid work model

In-office presence in TriState Area

Job summary

Independence Blue Cross, LLC is seeking a Behavioral Health Performance Manager to drive operational performance, resolve issues, and lead crossfunctional work across BH service, product, billing, and vendor changes. The role partners with BH leadership to ensure compliant, timely outcomes and high member experience.

The position emphasizes change management, claims oversight, and provider network coordination to stabilize operations and support regulatory requirements.

Qualifications

• Bachelor's degree in Business, Healthcare Administration, Public Health, Health Informatics, or related field required.
• Master's degree (e.g., MHA, MBA, MPH) preferred.
• 5+ years in healthcare, managed care, or behavioral health with operations, provider network, claims, or performance management.

Responsibilities

• Lead change management for BH service, product, billing, and vendor changes with coordinated implementation.
• Oversee claim escalations and AR-related resolutions across multiple teams.
• Manage provider data accuracy, credentialing, and network stabilization.
• Coordinate regulatory and executive issue resolution (PID, DOBI, DOL) with stakeholders.
• Maintain logs, trackers, and status reporting across BH operations.

Skills

Escalation management

Change management

Cross-functional collaboration

Provider network operations

Regulatory compliance

Education

Bachelor's degree in Business, Healthcare Administration, Public Health, Health Informatics

Master's degree (MHA, MBA, MPH) preferred

Tools

Microsoft Office

Microsoft Teams

Planner

Smartsheet

Job description

Independence Blue Cross, LLC is seeking a Behavioral Health Performance Manager to drive operational performance, resolve issues, and lead crossfunctional work across BH service, product, billing, and vendor changes. The role partners with BH leadership to ensure compliant, timely outcomes and high member experience.

The position emphasizes change management, claims oversight, and provider network coordination to stabilize operations and support regulatory requirements.