Claims Operations Lead
Job Summary
Leading the end-to-end transition and operational delivery of FACETS Claims Operations, the remote Claims Operations Facets Lead will manage client relationships, oversee claims adjudication operations, and drive transition planning and knowledge transfer to ensure operational readiness and stability.
Key responsibilities
- Act as the primary client-facing lead, managing executive stakeholder relationships and operational decision-making
- Drive transition planning and knowledge transfer execution, ensuring a successful handoff to delivery teams
- Establish governance processes and performance metrics to monitor operational performance and deliver visibility to stakeholders
Required qualifications
- 10+ years of Healthcare Payer Operations and BPM/BPO Operations experience with expertise in FACETS Claims Processing
- Proven experience leading large-scale transition and transformation engagements
- Strong understanding of Commercial, Medicare, Medicaid, and Government Programs claims operations
- Experience managing large-scale onsite/offshore BPM delivery teams
- Knowledge of SLA management and continuous improvement methodologies
Complete Job Description
The complete job description is available to members. Premium membership includes:
Full access to 41,934 remote jobs from human-vetted companies, updated daily
Resume Builder - AI-powered tool to craft, enhance, and tailor your resume to a specific job
Twice-monthly live group coaching and the full Remote Career Center
20% member discount on Career Services
Backed by a 30-day money-back guarantee
Company Company Name
Headquarters Headquarters
Founded Founded
Website
Wikipedia Wikipedia URL
The company description is available to members. Go Premium for full access to every job and company profile in our remote jobs database, backed by a 30-day money-back guarantee.
