Medical Operations Manager - Regulatory & Escalations

Description

Role Overview

The Medical Operations Manager - Regulatory & Escalations plays a critical execution-focused role within MEDvidi’s Medical Operations team. This position is responsible for owning day-to-day regulatory guidance, provider-facing operational support, issue investigation, and escalation management, ensuring that routine questions and operational matters are resolved efficiently and correctly without requiring Director-level involvement.

This role is intentionally designed to absorb and manage daily operational complexity, including provider questions, support escalations, and regulatory interpretation, allowing the Director of Medical Operations to remain focused on strategy, scaling initiatives, and executive-level priorities. The Medical Operations Manager supervises the Provider Administrative Support Team and works closely with Provider Relations Specialists, Care Managers, Quality Assurance, and cross-functional partners to maintain a compliant, provider-supportive operating environment across a multi-state telehealth platform.

Requirements

Skills and Qualifications

• Demonstrated strength in answering and guiding regulatory and operational questions within a healthcare or telehealth environment.
• Strong working knowledge of HIPAA, DEA regulations, state licensure requirements, PDMP, and telehealth compliance frameworks, mental health experience preferred.
• Proven ability to investigate issues, synthesize facts, and recommend clear resolutions independently.
• Experience supervising and managing support teams, including offshore or overseas staff, with HR partnership.
• Ability to balance provider advocacy with firm compliance boundaries.
• Highly organized, detail-oriented, and comfortable managing multiple concurrent issues in a fast-paced environment.
• Clear, concise communicator, particularly in written guidance, issue summaries, and leadership updates.
• Experience developing or maintaining SOPs, workflows, and operational policies.
• Familiarity with EHR and CRM platforms and telehealth operational tools.
• 5+ years of experience in medical operations, clinical operations, regulatory operations, or telehealth environments.
• Bachelor’s degree in Healthcare Administration, Business, or related field, Master’s degree a plus.

Responsibilities

Regulatory and Operational Guidance

• Serve as the primary point of contact for providers and internal teams regarding telehealth regulations, DEA requirements, PDMP, licensure, prescribing standards, and internal Medical Operations policies.
• Interpret regulatory and policy requirements and provide clear, practical guidance that supports compliant care delivery without unnecessary escalation.
• Identify recurring questions or areas of confusion and proactively recommend SOP updates, training needs, or workflow refinements to reduce operational friction.

Issue Investigation and Resolution

• Lead initial investigation, triage, and resolution of operational, clinical, or compliance-related issues raised by providers, support teams, or internal stakeholders.
• Develop clear issue summaries, root cause assessments, and recommended resolutions prior to escalation to the Director of Medical Operations.
• Partner with Quality Assurance to support incident reviews, documentation, and corrective action planning as needed.

Provider Support and Engagement

• Act as a trusted operational partner to providers by ensuring timely, accurate responses to day-to-day questions impacting workflows, documentation, prescribing, and care delivery.
• Support provider satisfaction and retention by reducing delays, confusion, and inconsistent guidance.
• Collaborate closely with Provider Relations Specialists and Care Managers to ensure alignment between provider communication, operational guidance, and escalation pathways.

Provider Administrative Support Team Management

• Directly supervise and manage the Provider Administrative Support Team, including offshore or overseas administrative assistants, in partnership with HR.
• This team provides non-clinical, technical, and administrative support only and does not perform clinical functions or require clinical licensure or certifications.
• Support scope includes technical and operational assistance such as access issues, EHR or prescribing platform troubleshooting, visit documentation workflow support, schedule coordination, and provider communications related to delays or operational disruptions.
• Establish clear expectations, workflows, and escalation criteria to ensure issues outside non-clinical scope are appropriately routed to clinical, compliance, or leadership teams.
• Monitor performance, identify training gaps, and implement ongoing coaching to maintain high-quality provider support.

SOPs, Workflows, and Operational Readiness

• Maintain and continuously improve Medical Operations SOPs, decision trees, and escalation protocols in alignment with current regulations and internal standards.
• Support rollout of new workflows, service lines, or tools by ensuring frontline teams are properly trained and equipped.
• Ensure continuity of operations during staffing changes, system issues, or regulatory shifts by implementing interim guidance and support plans.

Coverage and On-Call Support

• Participate in a rotating weekend on-call schedule to support operational continuity and timely issue resolution.
• Preference for candidates in Pacific or Mountain Time Zones to complement existing Medical Operations coverage and ensure adequate span of support across time zones.

Role Clarity Within Medical Operations

This role is distinct from the Medical Operations Manager responsible for Medical Records and Prior Authorization and works in close coordination with Provider Relations Specialists and Care Managers. The current Medical Operations Manager supervises the Provider Relations Specialists and owns provider KPI monitoring, schedule availability compliance, and capacity planning to ensure provider supply meets patient demand.

The Medical Operations Manager described in this role focuses on day-to-day regulatory guidance, issue investigation, escalation management, and supervision of the non-clinical Provider Administrative Support Team. This structure ensures clear ownership, reduces operational overlap, and allows the Director of Medical Operations to remain focused on strategy, scaling, and executive priorities.