Claims Operations Director

Job Summary

A company is looking for a Claims Director to oversee the operational performance of the claims department and drive strategic initiatives.

Key Responsibilities

• Manage day-to-day operations of the claims department, ensuring performance aligns with strategic goals
• Develop and implement client experience strategies while collaborating with cross-functional teams
• Lead and mentor claims management staff, fostering a culture of accountability and continuous improvement

Required Qualifications

• 7 years of experience in healthcare claims operations at a third-party administrator
• 5 years of leadership experience managing claims teams
• Deep knowledge of self-funded health plan administration and claims adjudication
• Experience with claims system implementation or transformation
• Strong data literacy and ability to interpret operational metrics