Operations Manager

Job Title: Operations Manager

Skills: Designing, building, scaling, and managing the day-to-day operational infrastructure, supports WISeR Providers and WISeR Clinicians

Experience: 9-12 Years

Location: Remote, USA

Job Type: Contract to Hire

We at Coforge are hiring for Operations Manager with the following skills:

• The Operations Manager, Provider Experience & Program Operations is a critical leadership role within the WISeR Model team.
• This individual will be responsible for designing, building, scaling, and managing the day-to-day operational infrastructure that supports WISeR Providers and WISeR Clinicians participating in the prior authorization and pre-payment review model within the assigned jurisdiction.
• Reporting to senior program leadership, this role serves as the operational backbone of the WISeR Model Team: designing the processes and systems that allow the team to deliver consistent, compliant, and high-quality service at scale. The ideal candidate is both a builder and an operator: someone who can design a process from scratch and then run it with excellence. Key Responsibilities Help Desk Support and Provider Inquiry Management.
• Establish, manage, and continuously improve a multi-channel help desk operation (phone, fax, email, portal) for WISeR Providers seeking guidance on prior authorization and pre-payment submissions.
• Define service level agreements (SLAs) for response and resolution times, monitor adherence and drive performance improvement.
• Build escalation pathways and triage protocols to route clinical, billing, and operational inquiries to the appropriate subject-matter resources.
• Oversee and support front-line staff in delivering accurate, compliant, and empathetic provider support.
• Own and manage operational in boxes and communication channels, ensuring timely and accurate responses to provider inquiries.
• Build templates, response libraries, and FAQs to improve efficiency and consistency across the Provider Services team.
• Monitor and report on communication volume trends. Standard Operating Procedures (SOPs) and Process Documentation.
• Author and maintain a comprehensive library of SOPs covering all operational workflows.
• Ensure SOPs are written to be clear, establish a version control and review cadence for all operational documentation; ensure SOPs are updated promptly when program requirements change.
• Train team members on SOPs and conduct periodic audits to confirm adherence.
• Build scalable workflows and handoff structures between help desk and clinical reviewers.
• Identify automation, technology, and tooling opportunities to streamline operations; partner with IT .