Director Claims Enablement Operations
New
United StatesFull-TimeDirector
Salary144,200 - 240,400 USD per year
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Job Details
- Experience
- 8+ years progressive leadership experience within Medical Claims Operations
- Required Skills
- Project ManagementRisk ManagementStakeholder managementChange Management
Requirements
- High School Diploma or GED required.
- Bachelor’s degree in Business, Operations Management, or related field preferred.
- 8+ years progressive leadership experience within Medical Claims Operations.
- Experience leading enterprise-wide initiatives, cross-functional teams, and large-scale operational change.
- Proven director-level experience influencing senior and executive leaders.
- Deep experience in operational transformation, automation strategy, and system modernization.
- Strong track record of delivering complex initiatives in highly regulated environments.
- Experience working within highly matrixed organizations.
- Strong risk management mindset.
- Exceptional stakeholder management and communication skills.
Responsibilities
- Lead and manage small to large cross-functional project implementation within Provider Operations.
- Serve as the primary escalation point for production support needs.
- Develop, manage, and mentor teams of subject matter experts.
- Define and lead the multi-year automation roadmap and system enhancements.
- Oversee Auto Adjudication performance and enhancement efforts.
- Define requirements and own post-implementation controls and governance.
- Lead system release cycles including testing and validation.
- Identify operational risks and implement mitigation strategies.
- Oversee budget and identify cost-saving opportunities.
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