Senior Manager, Business Operations – Payment Integrity
United States
Full Time
2 weeks ago
$104,500 - $155,000 USD
No Visa Sponsorship
Key skills
SQLAILLMAgileSales
About this role
Role Overview
Optimize payment integrity initiatives across internal, vendor, and AI-enabled workflows, maintaining full accountability for prepay and postpay performance.
Manage the health of audit queues by ensuring work inflow and outflow are accurately forecasted, balanced, and executed against SLA targets.
Monitor program KPIs—including savings, throughput, and audit yield—taking corrective action and optimizing vendor/AI-supported execution to meet goals.
Convert organizational strategy into actionable operational plans that align with savings targets, audit integrity, and regulatory compliance.
Bridge high-level strategic design with hands-on execution to build repeatable workflows and robust process controls that sustain performance during rapid growth.
Integrate LLM-driven automation and AI capabilities into operational workflows to streamline manual hand-offs and maximize cost efficiency.
Use data to identify root causes of inefficiencies across workflows and systems, leading the development of solutions to reduce future operational risk.
Requirements
Bachelor’s degree and 6+ years of professional experience in high-growth operations, strategy, or healthcare management.
Experience working with data-driven or AI-enabled workflows (no coding required) to drive operational impact.
Proven ability to drive results across Operations, Product, and Engineering.
A strong understanding of the US healthcare ecosystem and its financial 'pipes,' with the ability to navigate the claims lifecycle even if you aren't a niche billing expert.
The ability to manage and optimize complex, multi-layered processes across vendors, tools, and teams.
You are energized by the 'messy middle'—you can build processes where none exist and pivot gracefully as the company needs a shift.
Ability to use the company’s vision and values as a North Star when making difficult operational trade-offs.
Proficiency with SQL
Familiarity with agile methodologies or frameworks for managing complex, cross-functional initiatives
Tech Stack
SQL
Benefits
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