Manager, Operations Automation – Strategy

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead and nurture a team of analysts and operational specialists.

• Set performance objectives, track operational metrics, and offer coaching and professional development.

• Promote accountability, collaboration, innovation, and a culture of continuous improvement.

• Ensure that responsibilities, escalation paths, and service expectations are clearly defined across the team.

• Manage the Missing Claim Response workflow, which includes monitoring, investigation, escalation, and resolution.

• Identify operational risks, recurring response gaps, processing trends, and payer-specific challenges.

• Oversee the intake, triage, prioritization, and routing of operational tickets, known issues, and support requests.

• Create workflow standards and governance to enhance efficiency and minimize delays, redundant tasks, and ambiguous ownership.

• Guarantee the prompt resolution of production issues, client escalations, and operational support requests.

• Monitor, communicate, and resolve known issues and operational risks.

• Identify, prioritize, and execute automation opportunities.

• Collaborate with Product and Engineering teams to develop automated workflows, monitoring solutions, dashboards, and reporting capabilities.

• Assess processes for standardization, simplification, and ongoing improvement.

• Define business requirements, success metrics, and operational controls for automation initiatives.

• Measure and report on automation outcomes, including reductions in manual effort, processing time, and operational risk.

• Convert operational challenges into scalable solutions and strategic initiatives.

• Relay operational health, risks, trends, and opportunities for improvement to leadership.

• Assist in operational planning, capacity management, and service delivery strategies.

• Suggest operational priorities, process enhancements, monitoring capabilities, and technology investments.

⛳️ Requirements

• A Bachelor’s degree is required.

• Five or more years of experience in healthcare payer operations.

• At least three years of leadership experience managing operational, systems, analytical, or technical teams.

• Strong knowledge of healthcare claims processing and payer operations.

• Ability to identify opportunities for process improvement and automation, translating operational needs into actionable requirements.

• Experience in managing cross-functional relationships with Product, Engineering, Operations, Client Services, Account Management, and other stakeholders.

• Strong analytical, problem-solving, organizational, and decision-making skills.

• Excellent written and verbal communication skills, capable of conveying complex operational and technical information clearly.

• Preferred: experience managing configuration-driven solutions, transaction monitoring, or healthcare transaction workflows.

• Preferred: knowledge of EDI transactions, including 837, 835, 277CA, and HIPAA X12 standards.

• Preferred: familiarity with Jira, ServiceNow, Salesforce, dashboard development, workflow automation, reporting tools, and operational analytics.

• Preferred: experience defining requirements for automated workflows, alerts, monitoring solutions, and exception management.

• Must be able to use a camera for all virtual meetings.

• Must pass a drug test prior to beginning employment.

• Must meet U.S. employment eligibility verification requirements.

• Sponsorship, in any form, is not available for this position.

🏝️ Benefits

• Competitive salary.

• Bonus structure.

• HSA company contribution.

• Healthcare benefits.

• Vision benefits.

• Dental benefits.

• 401k match program available from day one.

• Unlimited PTO for salaried associates.

• 9 paid holidays.

• Wellness reimbursement up to $250/year for gym memberships, racing events, weight management programs, etc.

• Education reimbursement.

• Paid Parental Leave for birth and adoptive parents.

• Diversity & Inclusion teams and employee groups.

• Continuous learning resources and access to industry/technology experts.

• Camera/video capability for remote work.

• Community volunteering opportunities.