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Supervisor, Operations; Provider Disputes

Job in Redding, Shasta County, California, 96001, USA
Listing for: Blue Shield of CA
Full Time position
Listed on 2026-03-03
Job specializations:
  • Management
    Risk Manager/Analyst, Healthcare Management
Salary/Wage Range or Industry Benchmark: 80000 - 100000 USD Yearly USD 80000.00 100000.00 YEAR
Job Description & How to Apply Below
Position: Supervisor, Operations (Provider Disputes)

Your Role

The Provider Dispute Resolution (PDR) team researches and resolves issues causing provider abrasion and disputes. The Supervisor will report to the PDR Operations Manager. In this role you will manage a team of coordinators, focusing on coaching/engagement, inventory management, auditing the team, and providing valuable insight into areas of opportunity to improve the process.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high‑performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience
  • Requires a minimum of 5 years of prior relevant experience
  • Requires a minimum of 2 years of experience operating in a lead role or equivalent leadership training or manager training
  • 2+ years' experience with PDR requirements and Commercial knowledge including experience with Commercial claims processing preferred.
  • Ability to analyze data, summarize and present findings - apply critical thinking skills
  • Capability/experience with writing letters in response to provider disputes and P&Ps
  • Collecting, analyzing and interpreting provider claim and dispute data
  • Experience in detecting trends, escalations, staff issues with training/production/quality requiring management attention
  • Knowledge of inventory and workflow management
Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

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