Sr. Manager, Insurance Claims Operations
About The Position
The Senior Manager, Insurance Claims Operations leads supervisors and more than 40 Case Specialists managing healthcare insurance recovery cases representing approximately $1 billion in financial exposure. Reporting to the Senior Director of Recovery Operations, this role ensures cases are investigated, accurately developed, and ready for attorney recovery. The position owns people performance, case progression, capacity, quality, productivity, and financial stewardship. The role sets expectations and accountability, manages staffing and workload, and ensures high-value and high-risk cases receive appropriate attention. It establishes standards for recovery readiness, resolves barriers that could delay or limit recovery, and partners with attorney recovery leaders to improve handoffs and reduce downstream delays and rework. The Senior Manager monitors case inventory and uses data on value, age, progression, quality, and risk to prioritize work, identify performance gaps and bottlenecks, and direct resources. The role diagnoses operational issues, translates performance data into action, and measures whether changes improve case progression and outcomes. It also develops supervisors and Case Specialists through coaching, hiring, onboarding, training, and development, fostering ownership, urgency, accountability, and problem-solving.
Requirements
- At least 7 years of progressive experience in healthcare claims, insurance operations, subrogation, recovery operations, healthcare revenue cycle management, or a comparable high-volume healthcare financial operation.
- At least 5 years of people leadership experience, including leadership of managers, supervisors, or team leads.
- Bachelor’s degree or equivalent relevant professional experience.
- Demonstrated success leading large, high-volume operations with measurable expectations for quality, productivity, timeliness, and outcomes.
- Experience managing staffing, capacity, workload, and large case or claims inventories.
- Strong analytical and problem-solving skills, with demonstrated ability to use operational data to improve performance.
- Proven ability to develop frontline leaders and build accountability for measurable outcomes.
Responsibilities
- Lead and develop supervisors and more than 40 Case Specialists managing approximately $1 billion in financial exposure.
- Own performance across case progression, quality, productivity, timeliness, and recovery readiness.
- Set clear expectations and accountability for supervisors and Case Specialists.
- Manage staffing, capacity, workload distribution, and priorities based on case volume and business needs.
- Ensure higher-value and higher-risk cases receive appropriate attention, escalation, and financial stewardship.
- Ensure cases are fully investigated, documented, and prepared for attorney recovery.
- Establish consistent standards for recovery-ready cases and resolve gaps that could delay or limit recovery.
- Improve case progression and attorney handoffs; partner with attorney recovery leaders to reduce downstream delays and rework.
- Monitor inventory for aging, progression, quality, financial exposure, and barriers.
- Use case value, age, progression, and risk to prioritize inventory and direct team resources.
- Use operational data to identify performance gaps, bottlenecks, capacity issues, and emerging risks.
- Determine whether operational issues stem from people, training, capacity, process execution, or workflow.
- Translate performance data into clear priorities and actions, and measure the impact of operational changes.
- Coach and develop supervisors and Case Specialists, building supervisors into effective frontline leaders.
- Set performance expectations, address performance gaps, and foster ownership, urgency, accountability, and problem-solving.
- Build organizational capability through effective hiring, onboarding, training, and development.
Benefits
- Comprehensive medical, dental, and vision insurance.
- 401(k) retirement savings plan with employer match.
- Paid time off and paid holidays.
- Company-paid life insurance and short-term and long-term disability coverage.
- Employee Assistance Program with counseling, financial coaching, and legal resources.
- Health Savings Account with company contributions for eligible employees.
- Wellness, healthcare advocacy, and pet benefits.
- A high-performing, collaborative culture built on ownership, accountability, continuous improvement, and meaningful impact.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
