Head of Claims Operations

Job Summary

Leading a multidisciplinary team, the full-time remote Head of Claims Operations will manage claims processing, drive automation initiatives, and align operations with business objectives to enhance member experience in a rapidly growing health insurance model.

Key responsibilities

• Build and lead a high-performance Claims Operations team to ensure accurate and timely claims processing
• Drive AI and automation initiatives to improve claims processing efficiency and quality
• Align claims operations with business objectives, focusing on payment accuracy and regulatory compliance

Required qualifications

• 15+ years of operations experience, including 5+ years in healthcare
• 8+ years in senior leadership roles managing large teams in complex environments
• Experience in a high-growth, tech-enabled health insurance or benefits company
• Strong financial acumen with experience in budget and resource allocation
• Demonstrated results in deploying AI or automation in claims or complex operations environments