Director of Digital Claims Operations
This role requires associates to be in-office
3 days per week , fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidate resides within a commutable distance from an office. The
Director of Digital Claims Operations
leads a synergized digital and operations unit to implement strategies that achieve top-tier digitized service results. This role requires you to serve as an influential leader across departments to enhance operational digitization, streamline processes, reduce administrative costs, and ensure an outstanding experience for our members and providers. Key Responsibilities: Drive digital transformation initiatives that enhance claims operations and service delivery. Collaborate with organizational leaders to establish strategic plans and achieve shared objectives. Lead critical strategic work streams for transformational priorities, taking ownership of multiple special projects. Plan and manage the resources and efforts within the Digital Claims Operations organization. Effectively manage and resolve intra-organizational challenges in the best interests of the business. Execute company objectives and strategic goals within the Digital Operations domain. Oversee the implementation and management of digitization initiatives, ensuring a deep understanding of current and future operational processes. Ensure compliance with applicable state and federal regulations. Oversee strategic planning, budgeting, and contract compliance for various cost centers while integrating government regulatory requirements. Manage a comprehensive suite of applications by developing digitization forecasts and delivery plans. Ensure disaster recovery and business continuity plans are in place, monitored, and updated regularly. Provide operational guidance and system solutions to support functional areas 24/7. Plan and execute annual projects while maintaining profit and loss (P&L) accountability. Develop and nurture a strong team through effective training and organizational development practices. Implement and uphold the policies and procedures of the company and the Digital Operations team. Guide the direction of information systems and programming activities conducted by technical staff. Utilize reporting and analytics tools to monitor procedures and operational metrics for staff adherence. Build strong partnerships with market and digital leads, Benefits Administration, Provider Engagement and Contracting, Sales, and Internal Audit. Recruit, train, coach, support, and assess the performance of direct reports. Minimum Requirements: BA/BS degree in Information Technology, Computer Science, or a related field, plus a minimum of 8 years of experience leading technology teams and/or cross-functional projects; or a combination of education and experience that provides a similar background. 7 years of management experience is required. Preferred Skills and Experience: Experience in leading Claims Operations teams and strategy within a large healthcare payor environment is strongly preferred. A proven track record in driving Digital Transformation in a Claims operational context is highly desirable. Strong digital literacy is preferred. Experience in the health insurance industry is a plus. Claims operational experience is favored. Process Improvement/Six Sigma expertise is preferred. For candidates working in person or virtually in the below locations, the salary range for this role is $179,080 to $280,830. Locations: Illinois; California; Minnesota. In addition to competitive salary options, Elevance Health offers a comprehensive benefits package, including incentive programs, stock purchase plans, and 401(k) contributions (subject to eligibility). The salary offered considers various legitimate, non-discriminatory factors. Elevance Health is committed to offering equal pay opportunities regardless of gender, race, and other protected categories. Please note, Elevance Health only accepts resumes from agencies with a signed agreement. Unsolicited resumes will be considered the property of Elevance Health. About Elevance Health Elevance Health is dedicated to improving lives and communities while simplifying healthcare. As a Fortune 25 company with a rich history in the industry, we seek leaders passionate about making a difference for our members and communities. Culture and Values We foster a culture focused on advancing our strategy and encouraging personal and professional growth. Our values define our approach to achieving business success, benefiting consumers, associates, and the community alike. We provide a broad range of competitive rewards, including paid holidays, Paid Time Off, bonuses, medical, dental, vision, disability benefits, retirement plans, and wellness programs. Elevance Health operates under a Hybrid Workforce Strategy. Unless otherwise specified, associates must work at an Elevance Health location at least once per week. Specific onsite time requirements will be discussed during the hiring process. The health and safety of our associates and communities are a priority. Therefore, we require candidates in specific roles to be vaccinated against COVID-19 and Influenza. Elevance Health is an Equal Employment Opportunity employer. We encourage all qualified applicants to apply regardless of age, citizenship status, color, disability, ethnicity, gender, marital status, national origin, race, religion, sex, sexual orientation, or veteran status. Applicants requiring accommodation in the job application process may contact us for support. Qualified applicants with conviction records will be considered per applicable laws, including the Los Angeles County Fair Chance Ordinance and California Fair Chance Act.
3 days per week , fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidate resides within a commutable distance from an office. The
Director of Digital Claims Operations
leads a synergized digital and operations unit to implement strategies that achieve top-tier digitized service results. This role requires you to serve as an influential leader across departments to enhance operational digitization, streamline processes, reduce administrative costs, and ensure an outstanding experience for our members and providers. Key Responsibilities: Drive digital transformation initiatives that enhance claims operations and service delivery. Collaborate with organizational leaders to establish strategic plans and achieve shared objectives. Lead critical strategic work streams for transformational priorities, taking ownership of multiple special projects. Plan and manage the resources and efforts within the Digital Claims Operations organization. Effectively manage and resolve intra-organizational challenges in the best interests of the business. Execute company objectives and strategic goals within the Digital Operations domain. Oversee the implementation and management of digitization initiatives, ensuring a deep understanding of current and future operational processes. Ensure compliance with applicable state and federal regulations. Oversee strategic planning, budgeting, and contract compliance for various cost centers while integrating government regulatory requirements. Manage a comprehensive suite of applications by developing digitization forecasts and delivery plans. Ensure disaster recovery and business continuity plans are in place, monitored, and updated regularly. Provide operational guidance and system solutions to support functional areas 24/7. Plan and execute annual projects while maintaining profit and loss (P&L) accountability. Develop and nurture a strong team through effective training and organizational development practices. Implement and uphold the policies and procedures of the company and the Digital Operations team. Guide the direction of information systems and programming activities conducted by technical staff. Utilize reporting and analytics tools to monitor procedures and operational metrics for staff adherence. Build strong partnerships with market and digital leads, Benefits Administration, Provider Engagement and Contracting, Sales, and Internal Audit. Recruit, train, coach, support, and assess the performance of direct reports. Minimum Requirements: BA/BS degree in Information Technology, Computer Science, or a related field, plus a minimum of 8 years of experience leading technology teams and/or cross-functional projects; or a combination of education and experience that provides a similar background. 7 years of management experience is required. Preferred Skills and Experience: Experience in leading Claims Operations teams and strategy within a large healthcare payor environment is strongly preferred. A proven track record in driving Digital Transformation in a Claims operational context is highly desirable. Strong digital literacy is preferred. Experience in the health insurance industry is a plus. Claims operational experience is favored. Process Improvement/Six Sigma expertise is preferred. For candidates working in person or virtually in the below locations, the salary range for this role is $179,080 to $280,830. Locations: Illinois; California; Minnesota. In addition to competitive salary options, Elevance Health offers a comprehensive benefits package, including incentive programs, stock purchase plans, and 401(k) contributions (subject to eligibility). The salary offered considers various legitimate, non-discriminatory factors. Elevance Health is committed to offering equal pay opportunities regardless of gender, race, and other protected categories. Please note, Elevance Health only accepts resumes from agencies with a signed agreement. Unsolicited resumes will be considered the property of Elevance Health. About Elevance Health Elevance Health is dedicated to improving lives and communities while simplifying healthcare. As a Fortune 25 company with a rich history in the industry, we seek leaders passionate about making a difference for our members and communities. Culture and Values We foster a culture focused on advancing our strategy and encouraging personal and professional growth. Our values define our approach to achieving business success, benefiting consumers, associates, and the community alike. We provide a broad range of competitive rewards, including paid holidays, Paid Time Off, bonuses, medical, dental, vision, disability benefits, retirement plans, and wellness programs. Elevance Health operates under a Hybrid Workforce Strategy. Unless otherwise specified, associates must work at an Elevance Health location at least once per week. Specific onsite time requirements will be discussed during the hiring process. The health and safety of our associates and communities are a priority. Therefore, we require candidates in specific roles to be vaccinated against COVID-19 and Influenza. Elevance Health is an Equal Employment Opportunity employer. We encourage all qualified applicants to apply regardless of age, citizenship status, color, disability, ethnicity, gender, marital status, national origin, race, religion, sex, sexual orientation, or veteran status. Applicants requiring accommodation in the job application process may contact us for support. Qualified applicants with conviction records will be considered per applicable laws, including the Los Angeles County Fair Chance Ordinance and California Fair Chance Act.