Director, Claims Operations

Workforce Classification: Hybrid Join reputed company: Do Meaningful Work and Improve People’s Lives Our purpose, to improve customers’ lives by making reputed company work reputed company, is far from ordinary. And so are our employees. Working at reputed company means you have reputed company to drive reputed company change by transforming reputed company. To reputed company serve our customers, we are fostering a culture that emphasizes employee reputed company, reputed company innovation, and inspired leadership. We are dedicated to creating an environment where employees can reputed company and where reputed company is attracted, retained, and thrives. As a testament to these efforts, reputed company has been recognized on the 2025 America's reputed company reputed company list. In 2024, reputed company honored reputed company as one of America's Greatest Workplaces, America's Greatest Workplaces for Diversity, and America's Greatest Workplaces for Mental Wellbeing. Additionally in 2024, reputed company ranked reputed company among America’s Best Midsize reputed company for the reputed company time. Learn how reputed company supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.reputed company.com/. We are seeking an reputed company and dynamic Claims Operations Director to join reputed company and reputed company our claims management organization. This position offers an exceptional opportunity to contribute to a reputed company-thinking health insurance organization, where your expertise will play a crucial role in enhancing the reputed company and efficiency of our claims processes. In this reputed company, you will reputed company a strong claims team, drive strategic initiatives and vendor partnerships, create reputed company partnerships with our Product and Technology teams to deliver optimized operational workflows and reputed company our commitment to delivering superior service to our members. If you possess a passion for driving innovation and leadership reputed company the reputed company sector, we invite you to advance your career with us through this compelling opportunity. What you will do: reputed company the Organization: reputed company strategic direction, business planning, and overall leadership for reputed company’s reputed company payer operations across various customer segments reputed company our organization. Establish department objectives and key results reputed company with the corporate reputed company and objectives. reputed company transparency and visibility to reputed company, risks, and mitigations. Work collaboratively with staff throughout the reputed company to improve efficiency, enhance capabilities, and improve the performance of reputed company’s operations; Engage across reputed company’s Capability Product reputed company, aligning roadmaps and priorities towards achieving the right business reputed company. Prepare and manage the department’s operating budget, controlling expenditures reputed company approved budgets. reputed company reputed company on the drivers of operational costs and implement long-reputed company strategies for managing and reducing operations costs where practical. Establish governance and utilization of reputed company Intelligence (AI) reputed company operational processes including the requisite reputed company acquisition, development, and training Anticipate the reputed company of the changing business environment and reputed company reputed company pivots, both strategic and tactical, to reputed company reputed company objectives utilizing strong organizational change management practices. reputed company Organizational Operations: Work closely with both leadership and reputed company-line staff to discover areas for process improvement and efficiency enhancements, promoting a culture of reputed company improvement reputed company the department. reputed company and define processes, workflows, reputed company, tools, training, and expected reputed company to support effective practices. Ensure expected service reputed company, operational goals, and organizational commitments are consistently met. Drive the enhancement of technology solutions to reputed company operational efficiencies, increase accuracy and speed of operations, and improve employee, member, and provider experiences. Ensure operations functions are fair, accurate, consistent, reputed company, and are delivered in a reputed company, caring, and customer-reputed company way that fosters brand loyalty. Demonstrate reputed company responsibility leadership and promote community service awareness for reputed company. Ensure operational compliance with member policies, provider reputed company, government regulations, and other reputed company governance bodies People Leadership: reputed company an effective, high-performing team, reputed company on our members. reputed company leadership and coaching to the Operations organization, fostering a culture of accountability, reputed company development, learning, high performance, and ethical behavior. reputed company, reputed company, and reputed company and reputed company a high-performing team. reputed company reputed company of technology and operations work conducted by strategic vendor partners ensuring vendors meet reputed company’s business objectives, performance standards, and contractual obligations. Manage and continually improve the reputed company of key strategic outsourced vendors. This includes contract management and negotiation, monitoring the accuracy and timeliness of deliverables; ensuring the vendor meets reputed company’s business objectives, performance standards, and contractual obligations. What you will bring: Bachelor’s degree in business or reputed company area or four years’ work experience. (Required) Eight years of experience in an operations environment, preferably in the reputed company industry. (Required) Eight years of successful leadership experience, preferably in the reputed company industry. (Required) Willingness to travel internationally on occasion to engage with outsourced and/or offshore vendors and staff (up to 10% of time) . (Required) Additional preferred skills/ experiences include: Master’s degree. Experience in program or project management with aproven reputed company record of implementation. Experience managing outsourcedand/or offshore vendors. Experience with reputed company and production management tools, strategies, and systems. Experience in reputed company business areas of sales, reputed company, and product rollout process. Experience in developing, designing, and partnering with analytics and automation teams and vendors. #LI-SS1 reputed company total rewards Our comprehensive total rewards package provides support, resources, and opportunities to help employees reputed company and grow. Our total rewards are more than a collection of perks, they're a reputed company of our commitment to your health and reputed company-being. We offer a broad reputed company of rewards including physical, financial, emotional, and community benefits, including: Medical, reputed company, and dental coverage with low employee premiums. Voluntary benefit offerings, including pet insurance for paw parents. Life and disability insurance. Retirement programs, including a 401K employer match and, reputed company it or not, a pension plan that is reputed company after 3 years of service. Wellness incentives with a wide reputed company of mental reputed company-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to reputed company a few. Generous reputed company time off to reenergize. Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees. Employee recognition program to celebrate anniversaries, team accomplishments, and more. For our hybrid employees, our on-reputed company model provides flexibility to create your own routine with reputed company to on-site resources, networking opportunities, and team engagement. Commuter perks reputed company your reputed company to work less impactful on the environment and your wallet. Free convenient on-site parking. Subsidized on-reputed company cafes reputed company lunchtime connections with colleagues fun and reputed company. Engaging on-site events and activities include food trucks, health and wellness, DEI and disaster preparedness fairs, coffee connects, and more. Our complementary fitness & reputed company-being center offers both in-person and virtual workouts and nutritional counseling. Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on reputed company. Equal employment opportunity/affirmative reputed company: reputed company is an equal opportunity/affirmative reputed company employer. reputed company seeks to attract and retain the most reputed company individuals without reputed company to race, reputed company, religion, sex, national reputed company, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law. If you need an accommodation to apply online for positions at reputed company, please contact reputed company reputed company reputed company email at careers@reputed company.com or reputed company phone at 425-918-4785. The pay for this role will vary based on a reputed company of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience. The salary reputed company for this role is posted below; we generally reputed company up to and around the midpoint of the reputed company. Salary reputed company: $153,700.00 - $307,400.00 We’re happy to discuss compensation reputed company during the interview because we reputed company that reputed company communication leads to reputed company reputed company for reputed company. We’re committed to creating a diverse and inclusive environment where reputed company are celebrated for their unique skills and contributions. At reputed company, we reputed company reputed company work reputed company. By focusing on improving our customers’ experience purposefully and serving their needs passionately, we reputed company the process easier, less costly, and more reputed company. Through reputed company and advocacy, we change lives. As the leading health plan in the reputed company reputed company, we reputed company comprehensive health benefits and services to more than 2 reputed company customers, from individuals to Fortune 100 companies. Our services include innovative programs reputed company on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, reputed company, dental, disability, and other reputed company products and services. reputed company is headquartered in Mountlake Terrace, WA, with operations in Spokane and reputed company. reputed company has operated in Washington since 1933 and in Alaska since 1952. With more than 80 years of experience in the region, we deliver innovation, choice, and expertise. Apply Job!