Senior Manager, Member Claims

At Collective Health, we're transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.

As the Sr. Manager of Member Claims, you will oversee the entire Member Claims function, ensuring operational excellence, continuous process improvement, and alignment with the broader organizational goals. This leadership position will require a focus on optimizing performance across teams, building and evolving processes to support significant growth, and mentoring the next generation of leaders within the organization. You will be a key driver in shaping the future of our Member Claims operations, contributing to strategic initiatives that enhance the overall member experience and help us scale efficiently.
What you'll do:

• Strategic Leadership & Operational Excellence:
• Own the Member Claims function, including strategic planning, process development, and overall performance management.
• Lead the design, execution, and optimization of key claims adjudication processes that meet evolving business needs.
• Ensure the team meets and exceeds performance targets related to claims accuracy, timeliness, and efficiency.
• Identify long-term strategic initiatives to scale the Member Claims function, supporting company growth and operational excellence.
• Provide thought leadership and solutions to solve complex problems that arise from the rapid growth and complexity of the business.
• Team Management & Development:
• Lead and mentor a team of 5+ Team Leaders, ensuring that they have the resources and skills needed to drive team performance.
• Focus on leadership development, coaching, and performance management to ensure Team Leaders are equipped to support and develop their teams.
• Champion a culture of continuous improvement, ensuring all team members contribute to and benefit from opportunities for professional growth.
• Foster a collaborative, high-performance environment that aligns with company values and contributes to organizational success.
• Cross-Functional Collaboration & Strategic Initiatives:
• Collaborate closely with other departments (e.g., IT, Operations, Product, and Regulatory) to drive cross-functional projects that impact the broader organization.
• Work with senior leadership and stakeholders to prioritize initiatives and resolve issues that affect Member Claims' performance and capabilities.
• Lead efforts to integrate innovative solutions, improving both member satisfaction and operational efficiency.
• Process Improvement & Scalability:
• Continuously analyze claims processes, identifying bottlenecks and inefficiencies, and champion process improvements to streamline workflows.
• Ensure that claims processes are scalable and adaptable to meet the demands of the business as it continues to grow.
• Monitor industry trends and regulatory changes to proactively adapt claims processes, ensuring compliance and best practices are maintained.
• Data-Driven Performance Management:
• Leverage key performance metrics to monitor team performance and drive accountability.
• Utilize data to make informed decisions, improve claims handling processes, and communicate progress to senior leadership.
• Track trends and key metrics to continuously evolve the Member Claims operation and optimize the member experience.
• Cultural Leadership & Team Engagement:
• Serve as a key member of the Member Services Leadership team, fostering a collaborative culture that emphasizes transparency, accountability, and excellence.
• Promote a positive, inclusive, and high-performing office culture that aligns with [Company Name]'s values and mission.

To be successful in this role, you'll need:

• Experience:
• 8+ years of experience in operations management, with a focus on customer service, claims adjudication, or similar process-oriented environments.
• At least 5 years of leadership experience, including managing teams through periods of growth, change, and increased complexity.
• Proven track record in scaling operations, managing large teams, and optimizing complex processes.
• Skills & Competencies:
• Strong leadership skills with experience managing multiple teams and developing senior leaders.
• Strategic thinker with the ability to balance day-to-day operations with long-term planning.
• Excellent problem-solving skills and the ability to navigate complex challenges in a fast-paced environment.
• Analytical mindset with the ability to use data to drive decisions and monitor team performance.
• Strong communication and interpersonal skills, with the ability to influence and collaborate across departments.
• Education:
• Bachelor's degree or equivalent experience in a leadership capacity.

Pay Transparency Statement

This is a hybrid position based out of one of our offices: Plano, TX, or Lehi, UT. Hybrid employees are expected to be in the office three days per week (Plano, TX) or two days per week (Lehi, UT). #LI-hybrid #LI-DNI

The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/benefits/.

Lehi, UT Pay Range

$107,635-$134,000 USD

Plano, TX Pay Range

$117,500-$147,000 USD

Why Join Us?

• Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare
• Impactful projects that shape the future of our organization
• Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests
• Flexible work arrangements and a supportive work-life balance

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact recruiting-accommodations@collectivehealth.com.
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