Senior Lead of Strategic Operations

Primecare Benefits Inc. • Enterprise, NV

3d • Remote

About The Position

The Senior Lead of Strategic Operations oversees daily operational performance across customer service, referral and authorization, care coordination, and claims processing. The role is responsible for operational efficiency, compliance with service standards, timely processing, and effective staff management. It supervises approximately 10–15 employees, most of whom are union-represented, while maintaining productive labor relations and compliance with company policies and collective bargaining agreements.

This is a remote position, with occasional onsite attendance potentially required for meetings, trainings, operational needs, reviews, or leadership initiatives. The role requires maintaining a secure and professional remote work environment with reliable internet access.

Requirements

• Minimum of 3–5 years of healthcare operations or call center leadership experience.
• Prior supervisory or management experience.
• Strong leadership, organizational, and problem-solving skills.
• Excellent verbal and written communication abilities.
• Strong analytical and operational management capabilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office and operational software systems.
• Ability to maintain a secure and professional remote work environment with reliable internet access.
• Ability to work extended hours as operational demands require.

Nice To Haves

• Bachelor's degree in healthcare administration, business administration, operations management, or a related field preferred.
• Experience managing claims, referrals, authorizations, or healthcare customer service operations preferred.
• Experience working within a union environment strongly preferred.

Responsibilities

• Oversee day-to-day operations of the care coordination and claims departments.
• Develop and implement operational strategies to improve efficiency, service levels, and departmental performance.
• Monitor workflows to ensure operational goals and deadlines are achieved; identify challenges and implement corrective action plans.
• Ensure compliance with company policies, HIPAA regulations, and applicable contractual requirements.
• Manage the Care Coordinator team in the call center, including staffing and scheduling to maintain coverage and service standards.
• Monitor call center metrics, including abandonment rate, average speed to answer, call quality, and productivity, and ensure performance standards are met.
• Provide training, coaching, performance management, and operational support to Care Coordinators and supervisory staff.
• Oversee referral and authorization workflows and processing accuracy, ensuring processing within 48 hours of receipt.
• Monitor turnaround times and implement workflow improvements; resolve escalated referral and authorization concerns from providers, members, and staff.
• Manage claims operations to ensure timely and accurate processing, including prompt and accurate claims adjustments and corrections.
• Monitor claims aging, processing timelines, and productivity metrics; collaborate with leadership and vendors on claims-related operational concerns.
• Supervise, mentor, and support approximately 10–15 employees.
• Conduct performance evaluations and coaching sessions, and take disciplinary actions as appropriate.
• Maintain effective working relationships in a union environment and ensure compliance with collective bargaining agreements.
• Assist with recruitment, onboarding, and staff development initiatives.
• Foster a positive, collaborative, and service-oriented work environment.
• Support operational efficiency and continuous process improvement while maintaining accuracy, productivity, and customer satisfaction.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior