Retrieval Operations Lead

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.

Originally posted on Himalayas