Client Business Manager

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
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.
Maintaining accurate client contract documentation, DORs, SOWs, and SLA schedules for the assigned portfolio.
Contributing to team-wide operational improvements, including paper claims reduction, EFT/ERA adoption, OON reduction, 039 denial workthrough, and similar initiatives.
Managing daily work using multiple systems, including EMR systems, payer portals, Guidehealth applications, and Microsoft 365 (Excel, Word, PowerPoint, Outlook, Teams).
Collaborating with internal teams to deliver integrated services and a consistent client experience.
WHAT YOU’LL NEED TO HAVE
Bachelor’s degree preferred; Associate degree or equivalent experience considered.
3+ years of experience in healthcare operations, managed care, IPA operations, health plan operations, or a related field.
Experience owning or contributing meaningfully to client facing operational work, with demonstrated accountability for outcomes.
Demonstrated verbal and written communication skills, including the ability to listen actively, run structured client meetings, and communicate clearly with clients, health plan partners, and cross-functional teams.
Strong organizational skills and the ability to track multiple workstreams, deadlines, and deliverables across a client portfolio.
Strong analytical and problem solving skills, with the ability to work through operational issues across multiple functions and stakeholders.
Ability to manage a portfolio of clients and competing priorities independently in a fast paced environment.
Proficiency in Microsoft 365 (Excel, Word, PowerPoint, Outlook, Teams) and ability to learn multiple systems.
Driver’s license and reliable transportation (25% travel in Chicago area required).
WOULD LOVE FOR YOU TO HAVE
Direct experience with delegated services (UM, Claims, Credentialing, Eligibility, PHM, Quality, or CX) in an IPA, health plan, or delegated entity setting.
Familiarity with value based care contracts (shared savings, full risk, capitation) and PMPM based service arrangements.
Experience with SLA tracking, contract compliance reporting, and health plan or NCQA/URAC audit preparation.
Familiarity with claims workflows, eligibility files (834), capitation reconciliation, and payer portals.
Experience presenting operational and executive level reporting to client leadership.
Basic knowledge of EMR systems and healthcare data platforms.

Employment type
Full-time

Work arrangement
Yes