Manager, Digital Claims Optimization (AI)

Location: Telecommuter in one of the following states: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, or Wisconsin. Candidates living within 30 miles of Mountlake Terrace, Washington must work hybrid.

Salary: $118,900–$202,100 national range; $135,600–$230,500 national plus range for higher-cost labor markets including Western Washington and Alaska.

Company

hirify.global works to improve healthcare outcomes and customer experiences through health insurance services.

What you will do

• Lead digitization and automation of priority Claims Operations workflows using process automation and AI-enabled decisioning.
• Design scalable, controlled automated workflows and decision paths aligned with operational and enterprise claims needs.
• Build dashboards and operational reports to measure workflow performance, automation effectiveness, and implementation outcomes.
• Analyze data to identify bottlenecks and continuously improve automated workflows and processes.
• Own end-to-end delivery, including requirements, testing and UAT coordination, defect management, readiness sign-off, implementation, and adoption.
• Operate internal controls, oversee applicable third parties, and coach a team through delivery and change.

Requirements

• Bachelor’s degree in a technical or quantitative field, or four years of relevant experience.
• At least five years of experience digitizing and automating operational workflows, developing business applications, or performing data analysis and business intelligence reporting.
• At least two years of hands-on data analysis and reporting experience, including dashboards and operational reports.
• At least three years of management experience with accountability for delivery quality, team development, and leading teams through change.
• Experience with Power BI, Tableau, or equivalent business intelligence tools; familiarity with SDLC practices and backlog or ticketing tools.
• Ability to translate business and technology changes into practical operational outcomes.

Nice to have

• Experience scaling automation across multiple workflows or operational areas.
• Familiarity with claims operations or similar process-driven domains.
• Experience applying continuous improvement methods within automated operations.

Culture & Benefits

• Medical, vision, and dental coverage with low employee premiums.
• Life and disability insurance, a 401(k) employer match, and a pension plan vested after three years.
• Paid time off, wellness resources, counseling, stress management, and mindfulness programs.
• Tuition assistance for undergraduate and graduate degrees.
• Employee recognition programs and on-campus resources for hybrid employees, including parking, commuter perks, cafes, fitness facilities, and wellness activities.