Business Operations Senior Manager

About this role

Job Description

*A bit about this role:*

Our Payment Integrity Department ensures that provider claims are paid correctly by the responsible party, for eligible members, according to contractual terms, not in error or duplicate, and free of wasteful or abusive practices. As part of this function, the Business Operations Senior Manager is responsible for ensuring the success of Payment Integrity (PI)’s programs and processes.

The ideal candidate is a self-starter who enjoys taking accountability for operational performance, solving complex operational problems and driving impact in close collaboration with cross-functional stakeholders and teams.

*Your Responsibilities and Impact will include:*

• Operational Orchestration: Own the daily health of the operation—monitoring TAT (Turnaround Time), clearing backlogs, and ensuring queue health remains optimal.
• SLA & Quality Governance: Oversee operational performance and maintain the feedback loop between high productivity and rigorous audit accuracy.
• Program Design and Launch: own the end-to-end design, testing, and launch of scalable cross-functional workflows, including change management, training, and post-launch KPI tracking.
• Cross-Functional Partnership & Alignment: Partner closely with external vendors and cross-functional stakeholders across Engineering, Network/Provider Operations, Claims, and Integrations to align on ongoing operational priorities, streamline end-to-end workflows, and drive shared business outcomes.
• Efficiency & AI Integration: Identify opportunities to lean out manual processes by deploying and managing AI agents alongside human staff.
• Friction Removal: Act as the primary escalation point to resolve blockers for vendors and internal teams, ensuring they have the training and job aids needed to succeed.

*Required skills and experience:*

• 6+ years of experience in business operations or operational leadership
• Demonstrated success in driving meaningful change...