Manager, Advocacy & Dispute Resolution

• Case Oversight & Escalation

The range for this role is $83,000 to $114,000

Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education.

Interested applicants must be willing and able to work onsite at least four days out of the five day work week in either our Orlando, FL or Melbourne, FL office.

Connecting people to a Christ-centered community wellness experience based on faith, prayer, and personal responsibility.

Everyone at Christian Care Ministry is in agreement with our Statement of Faith, which outlines our core beliefs. Although we aren’t perfect people, we are serving our perfect God and our Members to the best of our ability.

The Manager, (Medical Bill) Advocacy & Dispute Resolution is accountable for the end-to-end design, operation, and performance of provider payment inquiry and disputes as well as the member balance bill Advocacy Program. This leader manages a team of Negotiators, Paralegals, and Member Bill Advocates whose mission is to protect members from unexpected out-of-network charges and to resolve provider payment inquiries and disputes.

The Manager ensures the program operates in compliance with the organization’s sharing program guidelines, oversees delegated third-party vendor performance against contracted service levels — including Zelis Healthcare (or other contracted vendor) for delegated provider inquiry and dispute response — delivers measurable financial protection to plan members, and provides data-driven program insights to plan leadership. The role requires equal strength in people leadership, vendor management, regulatory knowledge, operational execution, and stakeholder communication.

• Establish and continuously improve program policies, procedures, workflows, and quality standards for the full advocacy case lifecycle, including balance bill resolution, provider payment inquiries, and provider payment disputes
• Define program KPIs and success metrics in collaboration with plan leadership; lead quarterly business reviews and deliver monthly performance dashboards
• Develop and maintain a risk register for high-dollar, legally complex, or member-sensitive cases; present risk summary to VP quarterly
• Design and implement the staffing ramp strategy using the range model, activating additional FTEs when defined monthly case thresholds are sustained for 60+ days

• Provide effective management of staffing levels, performance, coaching, and development of member advocates, paralegals, negotiators and other Advocacy Team support roles
• Conduct regular 1:1 meeting with team members to ensure coaching, performance feedback and conflict resolution is addressed timely
• Design and deliver onboarding and training programs in coordination with the Training Team to ensure effective knowledge transfer, cross-functional education, and delivered quality to members and providers
• Designate and support embedded triage team leads to maintain effective day-to-day supervision
• Case Oversight & Escalation
• Review all open cases weekly to ensure compliance with resolution timelines, documentation standards, and communication requirements
• Serve as primary escalation authority for cases involving legal action, active collections, media attention, member disputes, or regulatory inquiries
• Authorize negotiation settlement parameters above negotiation-defined thresholds and approve cases proceeding to alternative dispute resolution or external legal counsel

• Establish and maintain policies, procedures, and quality standards covering the full lifecycle of provider payment inquiries and…