Claims Operations Senior Manager

Job Description

A bit about this role:

We are seeking an exceptional operator who combines strategic systems thinking with a relentless drive for execution. As the Sr. Manager, Claims Operations, you will ensure the day-to-day excellence of our claims engine while simultaneously designing the workflows and systems that will define its future.

The core function of this role is improving payment accuracy through identifying and resolving systematic issues throughout the claims lifecycle. You are someone who thrives on untangling the most "complex complexity," possessing the attention to detail required to peel back every layer of an operational challenge to find the root cause. Beyond diagnosis, you will be responsible for designing and implementing the next generation of policies, processes, and systems, leveraging AI to build a modern, technology-enabled service engine. You will deliver measurable outcomes, ensuring our operations are optimized for speed, accuracy, and scalability in a rapidly growing environment. This role is ideal for a builder-operator who runs toward hard problems and thrives in ambiguity.

Your Responsibilities and Impact will include:

• Issue Identification: End-to-end review of claims lifecycle to identity issues and vulnerabilities contributing to payment inaccuracies.

• Systemic Problem Solving: Delve into the most complex operational challenges, untangling intricate root causes to resolve persistent accuracy issues.

• AI-Native Workflow Design: Design, build, and implement the next generation of policies and processes, leveraging AI agents and automation to improve the accuracy and consistency of claim payments.

• Cross-Functional Partnership: Partner with Product, Engineering, and Data teams to ensure operational needs inform the technical roadmap and bridge the gap between business challenges and technical opportunities.

• Change Management: Lead the organization through significant evolution, creating confidence and momentum as you pivot teams to new ways of working.

• Strategic Execution: Execute a roadmap that modernizes operations while maintaining stability and high-quality standards.

Required Skills and Experience:

• Proven Leadership: At least 5 years of experience in complex operational environments with a track record of delivering measurable results.

• Systems Thinking: You can visualize the end-to-end lifecycle of a complex process and turn complexity into clear, repeatable business processes.

• Operational Rigor: Exceptional attention to detail and a reputation for "sweating the details" to get the hardest operational last mile right.

• Analytical Horsepower: Proficiency in leveraging complex data sets to inform strategic initiatives and drive data-driven narratives.

• Influence & Communication: Outstanding verbal and written communication skills, with a proven ability to influence senior leaders and cross-functional partners.

• Urgency & Resilience: Demonstrated ability to move quickly and maintain a high pace-setting standard in a fast-paced environment.

• Education: Bachelor’s degree required, or equivalent work experience.

Desired Skills and Experience:

• Familiarity with deploying AI-enabled workflows or automation to solve business challenges.

• Passion for experimentation, continuous learning, and building the next generation of operations.

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Salary range: $105,000 - $150,000 / year

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium

• Generous paid time off

• $100 monthly mobile or internet stipend

• Stock options for all employees

• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. 

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.