Business Solutions Manager - Remote United States

Responsibilities:

• Drive discussions and resolve operational frictions and Client relations matters in a timely manner. Escalate and/or report complex matters, as appropriate. 
• Lead regular strategic reviews that map technical delivery to the client’s business outcomes. 
• Build strong relationships with Client business leaders in Claims, Quality, and Member Experience. 
• Monitor boundaries between contract inclusive support and new scope by validating needs and, when needed, pivoting the requirement to a Change Order to protect profit and loss. 
• Collaborate with cross-functional teams, such as Customer Success, to manage billable hours and prevent over-servicing that requires non-billable hours. 
• Collaborate with Sales to Identify and qualify opportunities of expansion. 
• Identify opportunities for cross-selling and upselling within existing accounts. Lead the contract renewal process and maintain a high Net Promoter Score (NPS) across the payer sector.
• Provide regular reporting and analyses to leadership on Client status and account health.
• Ensure solutions remain market-fit and gather field intelligence to help Executives validate that product evolution matches shifting client requirements.
• Keep up-to-date on industry and market trends to drive Client discussions and inform product development. 
 

Requirements:

• 8+ years experience in account management, product management and/or equivalent experience working with or for Payers (Health Plans). 
• 1+ years of people leadership or people management experience, preferred. 
• Post-secondary education in Business or related field and/or equivalent relevant work experience. 
• 8+ years experience in account management, product management and/or equivalent experience working with or for Payers (Health Plans). 
• 1+ years of people leadership or people management experience, preferred. 
• Post-secondary education in Business or related field and/or equivalent relevant work experience. 
• Exceptional verbal and written communication, experience in translating technical matters to non-technical audiences. 
• Demonstrated ability to develop strong relationships with Clients, vendors and cross-functional teams. 
• Ability to drive results autonomously and demonstrate ability to assess complex matters and escalate accordingly. 
• Understanding of regulatory bodies such as CMS and their business impact on Payer organizations.
• Functional knowledge of healthcare interoperability and FHIR standards.
• Experience leading Executive Business Reviews (QBRs) that move beyond technical status updates to focus on strategic business value.

Additional Information:

• Smile discloses that artificial intelligence (AI) may be used in portions of the recruitment and selection process, such as resume screening or application assessment. All hiring decisions are ultimately made by qualified human decision-makers, and AI tools are used to support — not replace — fair and equitable hiring practices. 
• This position is a new role, created to support Smile’s continued growth and commitment to operational excellence.