Claims Operations Manager

Job Summary

Leading and optimizing end-to-end operational functions, the full-time Sr. Manager, Claims Operations will ensure accurate, timely, and compliant execution of pharmacy benefit services while managing a remote team and driving process improvements.

Key responsibilities

• Provide leadership and oversight over the claims operations team to ensure efficient and compliant execution of business operations
• Manage day-to-day operational performance, ensuring service levels and quality standards are met
• Drive continuous process improvement initiatives to enhance efficiency, accuracy, and quality across all claims operations core functions

Required qualifications

• Bachelor's degree in Business Administration or related field, or equivalent work experience
• 5+ years of claims operations experience
• 3+ years of progressive leadership experience
• Experience with specialty claims and complex programs such as copay assistance strongly preferred
• Experience in healthcare required