Claims Operations Senior Manager (Healthcare/AI)

TL;DR

Claims Operations Senior Manager (Healthcare/AI): Designing and optimizing claims processing workflows to improve payment accuracy with an accent on systemic problem solving and AI integration. Focus on building AI-native service engines and bridging the gap between operational needs and technical roadmaps.

Location: Remote (USA)

Salary: $105,000 – $150,000 / year

Company

hirify.global is an all-in-one healthcare company on a mission to improve the well-being of older Americans by combining insurance, clinical care, and technology.

What you will do

• Conduct end-to-end reviews of the claims lifecycle to identify systemic issues and vulnerabilities contributing to payment inaccuracies.
• Design and implement AI-native workflows and automation to improve the accuracy and consistency of claim payments.
• Partner with Product, Engineering, and Data teams to ensure operational needs inform the technical roadmap.
• Lead the organization through change management, pivoting teams toward modernized ways of working.
• Execute a strategic roadmap to modernize operations while maintaining stability and high-quality standards.

Requirements

• At least 5 years of experience in complex operational environments with a track record of delivering measurable results.
• Proven ability in systems thinking and translating complex processes into clear, repeatable business workflows.
• Must be based in the USA.
• Proficiency in leveraging complex data sets to drive strategic initiatives and data-driven narratives.
• Outstanding verbal and written communication skills to influence senior leaders and cross-functional partners.
• Bachelor’s degree or equivalent work experience.

Nice to have

• Experience deploying AI-enabled workflows or automation to solve business challenges.
• Passion for experimentation, continuous learning, and building next-generation operations.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and parental leave program.
• $100 monthly mobile or internet stipend.
• Stock options for all employees and bonus eligibility.
• 401K program.