Senior Manager Service Delivery

Gainwell Technologies LLC•Any city, OH

1d•$108,400 - $154,800•Hybrid

About The Position

We are seeking a Senior Manager to lead service delivery and operational execution for healthcare claims configuration and processing teams. This role will drive delivery excellence, quality, and continuous improvement across configuration, adjudication, and support functions to improve accuracy, efficiency, and client outcomes. Manages multiple clients and domain leads responsible for claims configuration, provider setup, and adjudication logic to ensure accurate and efficient delivery of business solutions. Drives standardization and implementation of process improvements across configuration lifecycle (design, build, test, deploy). Develops and manages demand forecasts with account and product teams, aligning configuration and delivery capacity with client priorities. Identify risks in workload, capacity, and delivery timelines and recommend mitigation strategies. Works with functional and technical teams to interpret regulatory, benefit, and pricing requirements into configuration solutions. Provides guidance on solution design, impacts to claims adjudication, and downstream processing. Prepares, recommends, and oversees operating and personnel budgets for assigned teams. Monitors spend against plan, identifies variances, and drives cost optimization while maintaining delivery quality and SLA commitments. Leads complex relationships between delivery teams, product engineering, and client stakeholders to ensure alignment on configuration changes, defect resolution, and release readiness. Resolves escalations and ensures timely issue resolution. Drives continuous service improvements focused on accuracy of configuration, reduction of defects, and improved turnaround times. Ensure delivery outcomes meet client expectations for quality, compliance, and timeliness. Partners with product engineering, QA, and operations teams to integrate new and enhanced capabilities into configuration frameworks and claims processing workflows. Supports new business initiatives by contributing to solution design, estimation, and proposal development, particularly in areas involving claims configuration, pricing, and benefit setup. Selects and hires employees with strong domain expertise in healthcare claims and configuration. Coaches and develop team members to enhance technical capability, domain knowledge, and leadership skills. Addresses performance issues and drives accountability for results.

Requirements

Bachelor's degree or higher in business administration, healthcare, information systems, or related field
Twelve (12) or more years of experience in healthcare technology, claims processing, configuration, or related delivery roles
Eight (8) or more years of leadership or supervisory experience
Experience working in healthcare payer systems, including Medicaid or Medicare environments
Experience working with core administration platforms such as QNXT, Facets, or equivalent healthcare claims systems
Demonstrates strong expertise in healthcare claims processing, including edit configuration and pricing methodologies, with advanced analytical and problem-solving capabilities (root cause analysis, defect reduction), and excellent communication and relationship-building skills to effectively collaborate with clients, stakeholders, and cross-functional teams while translating complex concepts into business terms.

Responsibilities

Manages multiple clients and domain leads responsible for claims configuration, provider setup, and adjudication logic to ensure accurate and efficient delivery of business solutions.
Drives standardization and implementation of process improvements across configuration lifecycle (design, build, test, deploy).
Develops and manages demand forecasts with account and product teams, aligning configuration and delivery capacity with client priorities.
Identify risks in workload, capacity, and delivery timelines and recommend mitigation strategies.
Works with functional and technical teams to interpret regulatory, benefit, and pricing requirements into configuration solutions.
Provides guidance on solution design, impacts to claims adjudication, and downstream processing.
Prepares, recommends, and oversees operating and personnel budgets for assigned teams.
Monitors spend against plan, identifies variances, and drives cost optimization while maintaining delivery quality and SLA commitments.
Leads complex relationships between delivery teams, product engineering, and client stakeholders to ensure alignment on configuration changes, defect resolution, and release readiness.
Resolves escalations and ensures timely issue resolution.
Drives continuous service improvements focused on accuracy of configuration, reduction of defects, and improved turnaround times.
Ensure delivery outcomes meet client expectations for quality, compliance, and timeliness.
Partners with product engineering, QA, and operations teams to integrate new and enhanced capabilities into configuration frameworks and claims processing workflows.
Supports new business initiatives by contributing to solution design, estimation, and proposal development, particularly in areas involving claims configuration, pricing, and benefit setup.
Selects and hires employees with strong domain expertise in healthcare claims and configuration.
Coaches and develop team members to enhance technical capability, domain knowledge, and leadership skills.
Addresses performance issues and drives accountability for results.