Senior Manager Member Claims

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 youll do:

• Strategic Leadership & Operational Excellence:
  
• Own the Member Claims function including strategic planning process development and overall performance management.
• Lead the design 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 longterm 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 highperformance environment that aligns with company values and contributes to organizational success.
  
  
• CrossFunctional Collaboration & Strategic Initiatives:
  
• Collaborate closely with other departments (e.g. IT Operations Product and Regulatory) to drive crossfunctional 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.
  
  
• DataDriven 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 highperforming office culture that aligns with Collective Healths values and mission.
  
  

To be successful in this role youll need:

• Experience:
  
• 8 years of experience in operations management with a focus on customer service claims adjudication and similar processoriented 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 daytoday operations with longterm planning.
• Excellent problemsolving skills and the ability to navigate complex challenges in a fastpaced 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:
  
• Bachelors 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). #LIhybrid #LIDNI

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 UT Pay Range