Senior Manager of Insurance Operations Systems

Systems Optimization, Assessment & Recommendations

• Oversee and enhance the credentialing and enrollment software system to meet NCQA standards, reporting requirements and cross-functional needs
• Develop a deep understanding of system capabilities to improve efficiency, visibility, and operational effectiveness
• Lead and drive initiatives aimed at improving end-to-end provider experience
• Take a proactive, project-based approach to identifying organizational needs and building scalable workflows
• Deeply understand the vendor and collaborative space regarding our current and potential future vendor solutions
• Leverage AI via internal and vendor solutions to improve quality and efficiency of the processes

Data, Reporting & Insights

• Develop reporting and insights by leveraging data from multiple systems (e.g., Verifiable, Internal tools, Looker, and Mode)
• Analyze the process and operational data to identify trends, surface opportunities, and inform decision-making
• Translate data into clear, actionable insights that drive continuous improvement, support people managers, and influence operations

Third Party Relationship Management

• Lead new vendor requests through the legal and security review process, ensuring satisfaction around regulation and compliance
• Ensure that vendor teams are appropriately resourced and meeting the agreed terms of the stream of work and signed contracts
• Act as liaison between third party product teams and internal product teams to ensure best coordination across systems

Cross Functional Coordination

• Identify opportunities for process improvement and implement scalable solutions that streamline internal coordination
• Serve as a key representative of Insurance Operations Systems across internal stakeholders, ensuring visibility and alignment