Mgr., Athlete Healthcare Navigator Operations

The Manager of Athlete Healthcare Navigator Operations plays a key role in overseeing the coordination of healthcare resources, Elite Athlete Health Insurance (EAHI) plan management, and customer service operations. This position will manage a team of Athlete Healthcare Navigators while ensuring efficient data reporting, developing educational initiatives, and creating streamlined processes to enhance operational performance. The Manager will balance managerial responsibilities with a reduced caseload, enabling a focus on team guidance, continuous program improvement, and the execution of tactical goals. 

Operational Oversight

• Manage and provide overall direction and leadership for the Athlete Healthcare Navigators, including staff selection, training, timekeeping, staff schedule alignment with budget, staff development, coaching, mentoring, and ongoing evaluation. Promote a collaborative work environment, fostering an athlete-centered team focused on values, continuous improvement, and professional development.
• Manage day-to-day operations, ensuring policy compliance, effective athlete support, and high-quality service delivery. Manage key operations, ensuring they meet organizational objectives and timelines.
• Support the development and optimization of workflows and algorithms; review and improve standard operating procedures to enhance efficiencies and ensure best practices are followed. Collaborate with the Athlete Healthcare Navigators to ensure execution of operating procedures.

Benefits Administration Oversight

• Manage benefits coordination, ensuring accurate primary and secondary claims processing in alignment with policies.
• Oversee enrollment and termination processes, conducting audits to ensure the integrity of member data.
• Ensure proper management of maternity benefits, prior authorizations, and other health plan-related processes.
• Oversee monthly processes such as, but not limited to, IRS Form 1099 reporting, premium deduction communication, and roster audits.
• Maintain ongoing knowledge of the Summary Plan Description (SPD).

Educational Planning

• Serve as project manager for initiatives to educate athletes and NGBs on available healthcare resources, benefits, and services.
• Collaborate with internal stakeholders to design and execute educational webinars, team presentations, and other materials to enhance athlete engagement and understanding of benefits.
• Proactively recommend methods and content to optimize communication with target audiences.
• Represent the Athlete Healthcare Navigator team in virtual and in-person group presentations and events.

Financial Assistance Support

• Oversee the day-to-day functions of the Medical Assistance and Mental Health Assistance Funds, ensuring compliance with policies and alignment with organizational standards.
• Review, process, and submit applications for the Medical Assistance and Mental Health Assistance Funds according to established policies and criteria.
• Assure accurate record keeping of financial records related to assistance fund applications; maintain operations of application dashboard and system.

Data Collection and Reporting

• Oversee data collection efforts, ensuring accurate monthly, quarterly, and annual reporting.
• Provide reports and insights on key metrics, trends, and areas for program improvement.
• Ensure the maintenance of accurate and timely records, reports, and files within the shared inbox, SharePoint, Electronic Health Records (EHR), and other systems so that team members can access relevant information.
• Research and classify community resources that may be of value to athletes and maintain a community resource database.
• Maintain confidential information in adherence with HIPAA regulations.

Case Management

• Assist with on-call phone and email support, addressing inquiries related to athlete benefits and resources, benefit coordination, EAHI support, and other inquiries.
• Provide proactive outreach initiatives by phone and email, as necessitated by the EAHI plan requirements, to provide individualized education regarding the USOPC healthcare resource options portfolio.
• Assess athlete and NGB needs, providing customized referrals to internal and external medical and financial resources as appropriate.
• Assist in benefits coordination by ensuring athletes and NGBs understand primary and secondary claims and actionable steps to execute the claims filing process accurately; provide follow-up and resource referrals as necessary.
• Assist athletes in navigating healthcare systems and overcoming barriers within the defined scope of practice.
• Develop and provide educational tools and information to empower athletes to make informed decisions about their healthcare.
• Serve as a Primary Point of Contact (PPC) for allocated sports to ensure familiarity, continuity, and enriched understanding of distinct needs.
• Provide support in athlete transportation to medical appointments.
• Provide other project support and related duties as assigned.

• Completion of a Bachelor’s degree in healthcare administration, human resources, social work, public health, or a related field or equivalent experience
• Certification in insurance (AINS or similar) or related professional credentials is a plus. 
• Patient Navigation Certification (ACS, PNTC, or similar) is a plus. 
• Must possess a valid driver’s license
• 4+ years of experience in healthcare, case management, administration, customer service, or human resources; specific experience in benefits administration preferred.
• Passion for sport and the ideals of the Olympic and Paralympic Movement.
• Skilled and knowledgeable in all aspects of healthcare benefits, including medical, dental, and vision
• Knowledge of federal and state laws as they relate to health and welfare plans
• Exceptional customer service skills
• Strong problem-solving and critical-thinking skills
• Detail-oriented with the ability to avoid and detect errors in a fast-paced, high-volume work environment
• Comfortable with public speaking
• Ability to establish and maintain effective professional relationships with all staff levels and external constituents
• Ability to work independently and as part of a team to meet deadlines and deliver high-quality service
• Demonstrated ability to handle sensitive information with discretion and maintain confidentiality
• Ability to deal with non-routine matters, competing priorities, and deadlines in a high-volume setting

• Microsoft Office software
• Electronic Health Records
• Standard office equipment
• Occasional domestic travel
• Motor vehicles/motorized carts
• Office environment, multi-building complex
• Flexibility is required for occasional evening, weekend, or holiday hours.

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