Manager, Claims Quality & Workforce Readiness

Premera Blue Cross•Mountlake Terrace, WA

3d•Remote

About The Position

As a Senior Manager, Claims Quality & Workforce Readiness, you will advance Premera’s Claims transformation by leading claims quality improvement, knowledge management, training, workforce readiness, and performance monitoring. You will build consistent practices that support high-quality outcomes and continuous improvement while helping the workforce adapt to automation, AI, analytics, and new ways of working. This role offers the opportunity to shape and build these capabilities as the Claims function evolves, and to strengthen the quality and effectiveness of claims processing for members.

Requirements

A bachelor’s degree or four years of relevant work experience.
Seven years of health plan industry or business/operational experience.
Four years of experience leading and managing teams of direct reports.

Nice To Haves

Health plan or healthcare operations experience, particularly within claims or another high-volume transactional environment.
Demonstrated experience leading complex operational functions and driving measurable improvements in quality, processes, and performance.
Experience building structure and capabilities in an evolving environment, leading change, solving complex problems, and building alignment across teams.
Experience using data, continuous improvement practices, technology, automation, analytics, or AI-enabled solutions to improve operational outcomes.
Experience building or governing knowledge management, training, workforce readiness, or operational performance programs.

Responsibilities

Build and lead a systematic quality-improvement approach across Claims Operations, using quality findings, operational data, and customer feedback to identify trends, address root causes, and reduce recurring errors and rework.
Partner with Quality Assurance and Claims production leaders to translate quality findings into corrective actions and sustained operational improvement.
Partner with Claims Optimization, IT, and other teams to use automation, analytics, AI, and technology to strengthen quality and continuous improvement.
Establish and govern a consistent approach to knowledge management, documentation, training, and workforce support across Claims.
Lead training specialists and partner with subject-matter experts to develop effective learning resources and consistent technical support practices.
Prepare employees for new systems, automation, AI-enabled workflows, and process changes, ensuring teams have the knowledge and support needed as claims work evolves.
Independently monitor Claims operational performance and inventory health to identify emerging risks and opportunities for improvement.
Partner with Claims production leaders on corrective actions and improvement plans while maintaining clear accountability for operational execution.
Use quality, performance, and workforce insights to prioritize improvement work and lead related cross-functional initiatives.
Build and develop a growing team responsible for strengthening Claims quality and workforce capabilities.
Coach and develop employees through clear expectations, meaningful assignments, feedback, and professional development opportunities.
Lead through ambiguity and change, helping define the structure, practices, and capabilities needed as the function evolves.

Benefits

Medical, vision, and dental coverage with low employee premiums.
Voluntary benefit offerings, including pet insurance.
Life and disability insurance.
Retirement programs, including a 401(k) employer match and a pension plan vested after three years of service.
Wellness incentives and mental well-being resources, including counseling, stress management, and mindfulness programs.
Generous paid time off.
Tuition assistance for undergraduate and graduate degrees.
Employee recognition program.
For hybrid employees, access to on-campus resources, networking opportunities, and team engagement.
Commuter perks.
Free on-site parking.
Subsidized on-campus cafes.
On-site activities, including health and wellness events, coffee connects, and disaster preparedness fairs.
Fitness and well-being center with in-person and virtual workouts and nutritional counseling.