Claims Operations Manager-Payment Accuracy

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Job Description A bit about this role: We're seeking a Claims Operations Manager to join an impact-oriented team focused on improving accuracy, reducing friction, and strengthening the integrity of our end-to-end processes. The team partners closely with Operations, Product, Engineering, Compliance, and Finance to identify breakdowns, uncover patterns, and maintain strong operations across the organization. This is an individual contributor role focused on investigation, root cause analysis, and process improvement. You will work through operational queues with rigor and curiosity, blending thoughtful analysis and pattern recognition to build durable fixes to complex problems. This role is ideal for someone who thrives in ambiguity, enjoys untangling messy challenges, and is motivated by improving systems at scale. You will have the opportunity to become the go-to point person on the team, while also helping shape how we leverage AI agents and LLM-powered tools across the department. Your Responsibilities and Impact will include: Conduct deep, end-to-end investigations into complex operational issues, identifying root causes across people, process, policy, and technology Work through designated queues with high attention to detail, ensuring well-supported and clearly documented determinations Translate individual errors or anomalies into broader themes, trends, and systemic improvement opportunities Partner cross-functionally (Operations, Product, Engineering, Compliance, Finance, etc.) to implement durable solutions Create clear documentation, decision frameworks, and feedback loops to prevent recurrence of known issues Use data to validate hypotheses, quantify impact, and measure improvement over time Explore and implement AI-driven solutions (including AI agents and LLM-supported workflows) to enhance investigation quality and automate repeatable analyses Serve as a trusted advisor and escalation point for ambiguous or high-impact operational issues Required skills and experience: Experience in operations, consulting, analytics, process improvement, or other complex problem-solving environments Demonstrated strength in root cause analysis and structured problem solving Proven ability to move from case-level detail to system-level insight Experience identifying process gaps and driving measurable operational improvements Strong analytical skills, including comfort working with data to identify trends and quantify impact Excellent written and verbal communication skills, with the ability to clearly explain complex findings and recommendations Ability to operate independently with sound judgment in ambiguous, fast-paced environments Strong cross-functional collaboration skills and ability to influence without direct authority Desired skills and experience: Experience in healthcare operations Experience building dashboards, tracking mechanisms, or structured issue management processes Curiosity and hands-on experience with AI tools, automation, or LLM-based workflows in operational settings #LI-Remote Salary range: $73,000 - $120,000 / year The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Healthcare equality is at the center of Devoted's mission to treat our members like family. We are committed to a diverse and vibrant workforce. At Devoted Health, we're on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and no

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