Claims Operations Manager

A company is looking for a Manager, Claims Operations to lead day-to-day operational activities related to claims processing and member communications.

Key Responsibilities

Establish team goals and manage achievement of objectives and key results (OKRs)

Identify process gaps and lead improvements in claims operations, focusing on automation

Oversee claims approvals, denials, and member communications during group transitions

Required Qualifications

5+ years in a leadership role with direct reports, preferably in a remote or hybrid setting

8+ years of experience in claims processing, medical billing, or pharmacy benefits

Experience with document management and member communication outreach preferred

Strong executive-level communication and interpersonal skills

Ability to lead teams in a fast-changing environment