Operations Manager

Brilliant Corners•Los Angeles, CA

3d•$80,000 - $82,000•Hybrid

About The Position

Founded in 2004, Brilliant Corners provides innovative housing and housing-related services to California’s most vulnerable individuals, with an emphasis on those transitioning from, or at risk of, homelessness or institutionalization. We develop, own, and manage multi-family supportive housing and licensed residential care homes. We implement a broad array of scattered-site, one-on-one supportive housing, and clinical case management programs through partnerships with developmental services, homeless services, veterans’ services, and health care sectors. The Operations Manager will serve as the operational owner of the Pear Suite billing and claims workflow for CalAIM Community Supports. This role is responsible for managing the full claims lifecycle from claim generation through submission, adjudication, reconciliation, denial management, and closure, ensuring that services provided are billed accurately, timely, and in compliance with payer and regulatory requirements. This position works closely with Data, Finance, Program, Compliance, and external billing vendors. The Operations Manager plays a critical role in safeguarding revenue, supporting audits, improving processes, and preparing the organization for expansion into additional counties and health plans.

Requirements

At least 2 years of experience in billing, claims, or revenue cycle management, preferably in healthcare, Medicaid, or public sector programs.
Preferred experience managing claims workflows and payer rules, including denials and corrections.
Experience working with billing and claims technology platforms (e.g., Pear Suite, clearinghouses, or comparable systems).
Experience supporting audits and compliance reviews strongly preferred.
A minimum of 3 years working in a social justice, human services, non-profit management, healthcare, or public policy agency.
At least two years of experience building and managing teams, experience overseeing contracts, budgets, and invoicing processes.
Demonstrated leadership as evidenced by increasing levels of responsibility and management over the course of the candidate’s career.
Familiarity with accounting principles, government contracting, and business process optimization.
Demonstrated ability in leveraging data to drive strategic decision‑making and system improvements.
Strategic and systems‑oriented leader with the ability to design, implement, and sustain inclusive and transparent decision‑making frameworks.
Strong communication, critical thinking, and independent judgment skills, with a creative and solution-oriented mindset.
Highly organized with strong project management, planning, and prioritization abilities, able to perform effectively under pressure and refine systems with a holistic, “big picture” perspective.
Effective communicator with the ability to lead, influence, and collaborate across diverse and cross‑cultural environments using an equity‑centered approach.
Proficiency with MS Outlook, Word, PowerPoint and Excel required; experience with databases such as Salesforce preferred.
Intacct software experience preferred but not required.

Nice To Haves

Experience supporting audits and compliance reviews strongly preferred.
Experience with databases such as Salesforce preferred.
Intacct software experience preferred but not required.

Responsibilities

Serve as the day-to-day operational owner of Pear Suite or similar for CalAIM Community Supports billing.
Manage and oversee the end-to-end claims lifecycle, from generation through screening, approval, submission, and final resolution.
Ensure claims are reviewed, approved, and submitted according to internal/Funder/DHCS- QC standards and payer timelines.
Monitor claim statuses and system dashboards to identify risks, delays, or systemic issues.
Monitor and enforce CalAIM billing timeliness requirements, including retroactive billing windows and corrected claim resubmission deadlines.
Oversee processes for PMPM billing logic and expected denial patterns to ensure accurate and compliant billing outcomes.
Support monitoring of service-specific lifetime caps (e.g., housing deposits, environmental accessibility adaptations).
Coordinate with program and compliance stakeholders when caps or billing limits are nearing or have been reached to ensure appropriate action.
Lead denial, rejection, and correction management processes, including review of ERA feedback and denial reason codes.
Determine appropriate paths (corrective action versus claim closure) and ensure corrected claims are reissued within resubmission limits.
Track and analyze denial and rejection trends; escalate issues that indicate upstream data, workflow, or system configuration gaps.
Manage denial and correction logs, ensuring complete documentation to support audits, reporting, and continuous improvement.
Identify and implement opportunities to improve billing workflows and improve efficiency to ensure clean claim rates.
Ensure compliance and quality control by contributing to the refinement of SOPs, job aids, and internal controls, and ensuring billing processes align with CalAIM, DHCS, health plan, and contractual requirements.
Support the onboarding of new regions, payers, and Community Supports as CalAIM expands.