Lead and manage cross-functional project implementation within Provider Operations
Drive continuous process improvement and foster a culture of innovation
Serve as the primary escalation point for production support needs
Develop, manage, and mentor teams of subject matter experts
Proactively communicate with a diverse range of stakeholders
Define and lead the multi-year automation roadmap
Oversee Auto Adjudication (AA) performance and enhancement efforts
Partner and define requirements, develop automations, and own post-implementation controls
Ensure compliant implementation and operational oversight for systems
Lead system release cycles and testing processes
Identify potential operational risks and implement mitigation strategies
Identify opportunities for cost savings while maintaining service delivery standards.

High School Diploma or GED required
Bachelor’s degree in Business, Operations Management, or a related field preferred
8+ years progressive leadership experience within Medical Claims Operations
Proven ability to operate at a director level, influencing senior and executive leaders
Deep experience in operational transformation, automation strategy, system modernization, and scaling innovation
Strong track record of delivering complex initiatives with measurable business impact
Demonstrated success working within highly matrixed organizations
Strategic thinker with the ability to translate vision into executable plans
Exceptional stakeholder management, communication, and executive presence
Strong risk management mindset
Excellent written, verbal, and active listening skills.

Operations Support Director, Claims

Key skills