Manager, Digital Claims Optimization

Requirements

• Bachelor's degree in a technical or quantitative field (e.g., computer science, information systems, engineering, data analytics, or a related discipline) is preferred or 4 years of relevant experience (Required).
• 5 years of experience in the following areas (Required):
• Digitizing and automating operational workflows, or
• Application development in a business environment, or
• Data analysis and business intelligence reporting.
• 2 years of hands‑on experience in data analysis and reporting, including building and using dashboards and operational reports (e.g., Tableau, Power BI) (Required).
• 3 years of management experience, including accountability for delivery quality, team development, and leading teams through change (Required).
• Experience scaling automation across multiple workflows or operational areas using repeatable delivery patterns.
• Familiarity with claims operations or similar process‑driven domains.
• Experience building dashboards and operational reporting using Power BI, Tableau, or equivalent BI tools.
• Familiarity with SDLC practices and backlog or ticketing tools.
• Practical application of continuous improvement methods within automated operations.
• Demonstrated ability to operate at the intersection of business and technology, translating system or automation changes into practical, operational outcomes.
• Premera total rewards
• Our comprehensive total reward

Benefits

Additional Information

Workforce Classification: Telecommuter Join Our Team: Do Meaningful Work and Improve People's Lives Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we're able to better serve our customers. It's this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/ . About the role of the Manager, Digital Claims Optimization Help redefine how claims work gets done-at scale and with purpose. As the Manager, Digital Claims Optimization , you'll lead the design and operational delivery of automation and AI-enabled workflow solutions that replace manual, repetitive work with reliable digital decisioning. You'll partner across Product, Technology, and Configuration to build well-controlled process automations, performance dashboards, and data-driven improvements that shorten cycle times, strengthen accuracy, and elevate the member experience. This is a hands-on leadership role for someone who wants to build, not just manage-someone energized by solving complex operational problems through smart use of technology and motivated by advancing Premera's values through thoughtful decisions and making healthcare work better for our members. The Manager, Digital Claims Optimization is responsible for transforming Claims Operations by translating business needs into scalable automation solutions and system enhancements. This role owns end-to-end operational delivery of automation initiatives-from process analysis and requirements definition through testing, implementation, and adoption into day-to-day workflows-and serves as the business owner for automation and enterprise changes impacting Claims Operations. Success in this role requires strong systems thinking, a data-driven mindset, and the ability to lead across teams, balancing hands-on solution development with coaching and developing a team to deliver impactful, sustainable outcomes. Note: Candidates that live within 30 miles of Mountlake Terrace, WA will be required to work hybrid. Impact that you will have: Drive the digitization and automation of priority Claims Operations workflows-using process automation and AI-enabled decisioning-to improve cycle time, accuracy, and customer experience. Design scalable, well-controlled automated workflows and decision paths that are aligned to operational needs and enterprise claims strategy. Build and maintain dashboards and operational reporting to measure workflow performance, automation effectiveness, and post-implementation outcomes. Use data to identify bottlenecks and continuously optimize workflows through targeted automation and process improvements. Own end-to-end delivery for claims automation and operational change (requirements, testing/UAT coordination, defect management, readiness sign-off, and implementation). Ensure strong governance by understanding and operating assigned internal controls and overseeing third parties (as applicable) in alignment with contracts and Premera standards.

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