Subrogation Manager

HealthPartners • Bloomington, MN

6d

About The Position

HealthPartners is hiring a Subrogation Manager. The Subrogation Manager is responsible for overseeing the end‑to‑end subrogation operations for the health plan, including identification, investigation, recovery, and collaboration with internal and external partners. This role ensures accurate detection of third‑party liability, optimizes recovery outcomes, strengthens compliance with regulatory requirements, and drives process efficiency across the subrogation lifecycle.

Requirements

• Bachelor’s degree or equivalent experience in insurance, healthcare administration, or related field.
• 5+ years of experience in healthcare subrogation, payment integrity, claims, or recovery operations.
• Strong knowledge of ICD‑10‑CM, EOB review, accident claim indicators, and payer subrogation processes.
• Experience leading teams or managing vendor relationships.
• Strong analytical skills with ability to interpret coding, documentation, and legal/contract language.
• Excellent communication and negotiation skills.

Nice To Haves

• Certification in claims, subrogation (e.g., CPIP, AIC), Paralegal is a plus
• Experience with Medicaid or Medicare TPL programs.
• Prior work with system‑based detection tools (e.g., flags, coding algorithms, recovery vendors).
• Working knowledge of legal terminology related to settlements, liens, and third‑party liability.

Responsibilities

• Operational Management Lead daily subrogation operations, including case intake, validation, investigation, prioritization, and recovery efforts.
• Develop and maintain workflows that improve identification of liability indicators such as external cause codes, accident details, workers’ compensation, and auto-related injuries.
• Monitor case inventory, productivity metrics, and recovery pipelines to achieve established financial targets.
• Leadership and Team Development Manage subrogation staff or vendor-aligned teams.
• Provide coaching, performance feedback, and training, documentation review, and process adhere
• Data, Analytics & Technology Enablement Collaborate with Payment Integrity, Claims, and Clinical teams to enhance detection logic, data mining rules, and system-driven triggers.
• Partner with IT or analytics teams to refine algorithms identifying potential third-party liability, including missed opportunities.
• Track and report key performance indicators (KPIs), root causes, and recovery trends.
• Vendor and Legal Oversight Manage relationships with subrogation vendors, law firms, and external recovery partners.
• Review vendor performance, ensure SLAs are met, validate case decisions, and handle escalations.
• Support legal review of complex cases, settlements, denials, or disputes.
• Cross Function Collaboration Work closely with Claims Operations to improve documentation completeness, coding accuracy, claim notes, and accident-related indicators.
• Partner with Compliance, Regulatory, SIU, and Finance to ensure alignment with state/federal requirements (e.g., Medicaid TPL, Medicare coordination of benefits).
• Collaborate with Provider Relations to address provider inquiries or education needs related to accident-related claims.
• Compliance & Quality Assurance Ensure regulatory adherence (ERISA, Medicaid TPL, state mandates) and maintain audit-ready documentation.
• Implement policy updates to address regulatory changes or audit findings.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager