Claims Operations Manager-Operational Transformation locations Remote USA time type Full time job requisition id R3157 Job Description A Bit About This Role: We are on a journey to modernize and transform our entire claims system end-to-end. As a Claims Operations Manager, you will lead the transformation of how we reimburse members for supplemental and medical expenses. We are looking for a high-impact operator—someone who doesn’t just suggest ideas but owns the high-stakes operational ecosystem. You will be responsible for the health, scalability, and performance of our reimbursement engine, ensuring every process is built for accuracy and compliance. Your Responsibilities and Impact: - System Transformation: Lead the end-to-end modernization of member reimbursement workflows for medical and supplemental expenses. - Operational Deployment: Act as a hands-on operator by taking our internal toolkit—including AI, workforce, and data platforms—and deploying them to hit specific business outcomes. - Outcome Ownership: Define and own the "Source of Truth" for program health, moving beyond reporting to ensure performance metrics are met or exceeded. - Performance Governance: Build and manage BI dashboards to track KPIs, identifying trends and taking immediate corrective action to keep the system on track. - Compliance Engineering: Own the integrity of the program by building processes that ensure 100% compliance with internal and external regulations. Required Skills and Experience: - The Operator Mindset: You are a builder who focuses on execution. You define a complex endpoint and use your toolkit to get there, using quantifiable mile markers to track progress. - Analytical Horsepower: Proven ability to use complex data sets to drive performance and influence organizational outcomes. - Technical Deployment: Proficiency with BI platforms (e.g., Snowflake, Looker, Tableau) and a track record of using LLMs or automation to solve business problems. - Conversational Agility: Ability to translate complex technical or financial concepts into actionable plans for any audience. - Extreme Organization: An elite eye for detail with the ability to pivot between tactical "in the weeds" tasks and high-level goal alignment. - Educational Foundation: Bachelor’s degree required, or equivalent experience in a high-growth or regulated environment. Desired Experience: - High-Growth Operations: Background in healthcare technology, management consulting, or tech-ops where you thrived by delivering results in ambiguous environments. - Systems Expertise: Success in becoming an SME in complex tools or regulatory frameworks to drive better business outcomes. - Relationship Management: Experience building collaborative, performance-driven relationships with cross-functional partners and offshore teams. Salary range: ​$73,000 - $125,000 / 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....