Director, Claims Operations

The Director, Claims Operations leads end‑to‑end claims functions, including processing, payment recovery, analysis, and provider appeals for a large nonprofit health plan. This senior leader is accountable for operational performance, cost management, and quality outcomes while driving scalability, standardization, and continuous improvement across a matrixed environment. The role also partners cross‑functionally with finance, IT, compliance, and other teams to ensure accurate, timely claims outcomes and represents claims operations in governance forums.