Subrogation Specialist

Role & responsibilities

Subrogation Manager

Key Responsibilities

• Oversee subrogation operations, including internal teams and multiple vendor partners managing first-pass and second-pass recovery efforts.
• Direct the identification, pursuit, and resolution of subrogation cases across a broad spectrum of liability types.
• Develop and maintain policies, workflows, and escalation protocols to support efficient and compliant subrogation operations across Medicaid, Medicare, and Marketplace populations.
• Collaborate with legal, claims, provider relations, finance, and compliance departments to ensure coordination and alignment on recovery efforts.
• Monitor case outcomes and vendor performance to ensure recovery goals are met or exceeded.
• Conduct regular quality assurance reviews of subrogation case files and provide coaching or corrective action as needed.
• Analyze trends in recoveries and provide recommendations to improve operational effectiveness and financial performance.
• Lead training, coaching, and development of subrogation staff to maintain high performance and technical knowledge.
• Prepare performance dashboards, recovery reports, and operational updates for senior leadership.

Preferred candidate profile

5+ years of experience in healthcare subrogation or legal recovery, including direct oversight of multiple subrogation case types.

• 3+ years of experience in a leadership or management role, including responsibility for both internal staff and vendor oversight.
• Experience working within a Managed Care Organization (MCO) or health plan environment.
• Proven ability to manage complex vendor relationships and recovery strategies (e.g., first-pass and second-pass vendor models).
• Strong understanding of federal and state regulations related to subrogation, including HIPAA, Medicaid TPL requirements, and CMS guidelines.
• Excellent analytical, negotiation, communication, and team leadership skills.