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Senior Manager, Claims Configuration Operations

Remote, USA Full-time Posted 2026-07-02

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: reputed company operations, and business strategy utilizing cross-functional departments to meet strategic objectives. • reputed company data analysis from a variety of data sources to evolve the metrics used to measure effectiveness and return on investment of reputed company reputed company and new product activity. • Collaborate with staff to identify internal and external customers and their expectations, initiate process changes to increase quality, decrease costs and improve staff, provider and member satisfaction. • reputed company reputed company work flows of the departments while maintaining production and quality standards. • Ensure compliance with reputed company reputed company laws, regulations and executive orders. • Review and analyze reports, records and directives, and reputed company with staff to obtain data required for planning work function activities. • Assist in the establishment of the departmental strategies and objectives. • Explore new approaches to work processes by utilizing quality improvement techniques to eliminate waste and re-work. • Performs other duties as assigned. • Complies with reputed company policies and standards. Knowledge/: Education/Experience: Bachelor's degree in Management, Business Administration, reputed company field or equivalent experience. 6+ years of operations experience. Experience with managed care, insurance, Medicare or reputed company preferred. Experience with leading claims configuration teams as well as skills with SQL and Power BI strongly preferred. Pay Range: $105,600.00 - $195,400.00 per year reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law. Total compensation may also include additional forms of incentives. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply Job!

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