Senior Vice President, Claims Services and Solutions

📋 Description

• Provide executive leadership for healthcare payer Claims Services org.
• Build and scale a multi-client claims operating model across lifecycle.
• Drive quality, turnaround time, productivity, backlog, and SLA performance.
• Lead recovery for high-risk or underperforming claims environments.
• Establish QA, audit, governance, and knowledge management practices.
• Partner with Technology/Product to deliver workflow, dashboards, automation, and AI-enabled quality

🎯 Requirements

• 15+ years in healthcare payer claims (processing, adjudication, quality, performance).
• 10+ years in claims operations leadership in payer services or similar.
• Proven success improving quality, reducing backlog, and rebuilding client confidence.
• End-to-end knowledge of claims processes and lifecycle.
• Experience with California healthcare payer markets and related environments.
• Executive client relationship experience (QBRs, governance, renewals).

🎁 Benefits

• Competitive executive-level compensation.
• Fully remote position based in the United States.
• Opportunity to lead a strategically important organization during growth/transformation.
• Executive visibility over claims strategy, technology modernization, and client experience.
• Collaboration with Sales, Client Services, Technology, Product, and Leadership.
• Opportunity to shape technology-enabled claims solutions with automation and AI.