IDR Senior Case Resolution Manager

Alacura Medical Transport Management is the leading benefit management company specializing in medical transportation. Alacura’s mission is to simplify air and ground medical transportation for patients, health insurers, hospitals and transport providers. Alacura’s tech-enabled platform supports commercial and Medicare Advantage populations, focusing on improving transport quality, safety, and improved health outcomes while protecting patients from financial harm. Alacura’s solutions are tailored to provide the most appropriate mode of transport (ground ambulance, rotary-wing, or fixed-wing) to support patient’s individual needs.

Alacura Transportation Medical Management is seeking an experienced IDR Case Resolution Manager to oversee the resolution of Independent Dispute Resolution (IDR) and arbitration cases related to air ambulance services under the No Surprises Act (NSA) and applicable state regulations.

This role is responsible for managing a portfolio of high-value air disputes on behalf of health plan payers, coordinating case strategy, preparing arbitration submissions, evaluating reimbursement positions, and driving favorable dispute outcomes. The ideal candidate will have direct experience managing IDR cases for health plans or payer organizations and possess a working understanding of the air ambulance reimbursement landscape, provider operations, and federal dispute resolution requirements.

The IDR Case Resolution Manager serves as a subject matter expert, ensuring compliance with federal and state regulations while supporting Alacura's mission of delivering cost-effective, clinically appropriate transportation solutions.

Key Responsibilities

IDR Case Management

• Manage the full lifecycle of federal and state IDR cases involving air ambulance transportation claims.
• Review and assess arbitration eligibility, timelines, and supporting documentation.
• Coordinate IDR initiation, evidence submission, determination review, and post-award analysis.
• Ensure all cases meet CMS and state-specific filing requirements and deadlines.

Case Strategy & Resolution

• Evaluate disputed claims and determine appropriate payer case dispute strategies
• Develop persuasive written submissions, position statements, and supporting documentation for certified IDR entities.
• Monitor arbitration outcomes and develop recommendations to improve future dispute strategies.

Air Ambulance & Transportation Expertise

• Review transportation claims involving fixed- and rotor-wing.
• Understand operational, clinical, geographic, and acuity factors impacting air ambulance reimbursement.
• Collaborate with UM operations, network management, clinical teams, and health plan clients to obtain supporting evidence.
• Stay informed on evolving regulations impacting air ambulance reimbursement and the No Surprises Act.

Compliance & Reporting

• Maintain accurate case documentation and audit-ready records.
• Ensure compliance with HIPAA, CMS regulations, federal NSA requirements, and applicable state laws.
• Track dispute metrics, recovery outcomes, win rates, and financial impact.
• Prepare reports and analyses for leadership regarding dispute trends and arbitration performance.

Leadership & Collaboration

• Serve as a resource for internal teams regarding NSA and IDR processes.
• Acts as the day-to-day liaison for health plan clients for coordinating case write ups and timely submissions.
• Assist in developing dispute resolution workflows, templates, and best practices.
• Participate in training and mentoring team members involved in dispute resolution activities.

Required Qualifications

Education

• Bachelor's degree in Healthcare Administration, Business, Finance, Legal Studies, Public Health, or related field preferred.
• Equivalent combination of education and experience will be considered.

Experience

• Minimum 3 years of direct Independent Dispute Resolution (IDR) case management experience on behalf of health plan payers.
• Experience managing No Surprises Act disputes through the Federal IDR process, specifically for air ambulance disputes
• Proven experience preparing arbitration submissions and managing dispute portfolios.
• Client Management and relationship building experience.
• Experience working with transportation benefit management organizations, health plans, TPAs, or managed care organizations.

Knowledge & Skills

Strong knowledge of the No Surprises Act (NSA) and the Federal IDR process and CMS regulations.

Working knowledge of the air ambulance transportation industry, including reimbursement challenges and operational considerations.

Exceptional analytical and problem-solving abilities.

Strong written communication skills with the ability to prepare persuasive dispute narratives and arbitration submissions.

Advanced proficiency in Microsoft Excel, Word, and case management systems.

Ability to prioritize multiple deadlines in a fast-paced regulatory environment.

Ability to work independently and self-direct their own work.

Why Alacura Transportation Medical Management?

At Alacura, we are transforming the management of medical transportation services by combining clinical expertise, operational excellence, and cost-management strategies that deliver value to patients, providers, and health plans. The IDR Case Resolution Manager plays a critical role in protecting payer interests while ensuring fair, compliant, and efficient resolution of complex transportation reimbursement disputes.

Physical Demands

Physical demands described here are representative of those that must be met by an employee to successfully perform essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

While performing duties of this job, the employee is frequently required to sit. The employee is occasionally required to stand, walk, climb or balance, stoop, kneel, crouch or crawl, reach with hands and arms, use hands to finger, handle or feel, talk, hear and smell. The employee is required to maintain adequate physical conditioning to be able to perform job duties. Job duties are often performed at high stress levels requiring employee to function effectively and independently while maintaining good working relationships with partners, employees, and customers.

The employee may frequently lift and/or move up to 25 pounds and may occasionally lift and/or move between 26-100 pounds. There are no specific vision abilities required to perform this job.

Work Environment

Work environment characteristics described here are representative of those an employee encounters while performing essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Employee shall typically be working from a home environment.

Alacura provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

FLSA Status: Exempt

Job Type: Full-time

Pay: $50,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Paid time off
• Tuition reimbursement
• Vision insurance

Work Location: Remote