Director of Claims Operations
New
S
Sidecar HealthHealth Insurance
Transform healthcare in the United StatesFull-TimeDirector
Salary not disclosed
Apply NowOpens the employer's application page
Job Details
- Experience
- 15+ years of operations experience, including 5+ years in healthcare; 8+ years in senior leadership roles
- Required Skills
- Data AnalysisProcess improvementChange ManagementBudget management
Requirements
- 15+ years of operations experience, including 5+ years in healthcare.
- 8+ years in senior leadership roles leading large teams in complex environments.
- Experience operating in a high-growth, tech-enabled health insurance or benefits company.
- Proficiency in building and interpreting operational dashboards.
- Proven ability to lead through ambiguity and manage cross-functional stakeholders.
- Strong financial acumen with experience owning budgets and headcount planning.
- Demonstrated results deploying AI or automation in claims or complex operations.
Responsibilities
- Lead and scale a multidisciplinary Claims Operations team spanning claims adjudication, quality, operations, and clinical.
- Foster a culture of metrics-driven continuous improvement and accountability.
- Identify and lead automation initiatives to increase end-to-end auto-adjudication rates and reduce processing time.
- Partner with Product and Engineering to shape the roadmap for claims technology.
- Lead change management efforts for new tools and workflows.
- Build and maintain governance structures for compliant, data-informed operations.
- Align claims operations with broader business objectives including sustainable MLR.
- Drive payment accuracy, fraud prevention, and claims spend optimization.
- Translate operational data into strategic insights for senior leadership.
- Manage budget development, resource allocation, and regulatory compliance.
View Full Description & ApplyYou'll be redirected to the employer's site
