Manager, Payer Operations

📋 Description

• Oversee 130+ payer data integrations; transform raw data into insights.
• Lead cross-functional teams; escalation point for high-priority data issues.
• Partner with Product, Tech, and Payer Strategy to automate monitoring.
• Move from reactive troubleshooting to predictive, automated monitoring.
• Ensure healthcare regulations and data security standards compliance.
• Translate complex data challenges into actionable business solutions.

🎯 Requirements

• Bachelor's degree in Healthcare Admin, Data Analytics, Info Systems, or related field (or equivalent).
• 5+ years in healthcare data ops, payer relations, or health informatics; 2–4 years in leadership.
• Advanced SQL for data investigation; familiarity with data observability tools (e.g., Tableau) and SFTP.
• Deep understanding of payer data structures (claims, clinical feeds) and HEDIS/MA Stars.
• Proven ability to lead teams through complex technical troubleshooting; manage high-volume queues (Jira).
• Exceptional communication; ability to influence decision-makers and payer relationships.

🎁 Benefits

• Flexible remote work schedules
• Health, dental and vision insurance paid up to 80%
• 21 days PTO in first year
• Two paid volunteer days and 11 paid holidays
• 12 weeks paid parental leave
• 401(k) with up to 4% match and stock options