Senior Manager, State Arbitration

At Zelis, we Get Stuff Done. So, let’s get to it!

Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

This role is responsible for overseeing multiple teams or a large, complex team within the claims negotiation function. This role focuses on driving operational excellence, implementing strategic initiatives, and ensuring compliance across all claims processes. This role partners with leadership to set goals, monitor performance, and lead process improvement efforts that enhance efficiency and customer satisfaction.

• Lead and manage multiple teams of negotiators, ensuring alignment with organizational objectives.
• Develop and implement departmental strategies to optimize claims resolution outcomes.
• Oversee high-value and complex claims negotiations, providing guidance and approval as needed.
• Monitor performance metrics and drive continuous improvement initiatives.
• Collaborate with senior leadership to establish policies, procedures, and best practices.
• Analyze claims data to identify trends and recommend strategic improvements.
• Build and maintain strong relationships with internal and external stakeholders.
• Ensure compliance with regulatory requirements and company standards.
• Provide training, support, and development opportunities to team members to ensure high performance and engagement.
• Conduct regular performance reviews, provide feedback, and identify opportunities for professional development.

• Typically has Bach. +12 yrs.;
  Masters +8 yrs. Attends company training and regional training in area of expertise. Presents own work to members of department and external consultants and external professional conferences, Collaborates externally, Hosts external guests, visitors and consultants
• Requires proficiency using AI tools skillfully with an understanding of how to develop/create intelligent prompts and/or agents.
• Experience leading multiple teams or large-scale projects.
• Strong strategic thinking and execution capabilities.
• Ability to influence cross-functional stakeholders and drive alignment.
• Advanced leadership and coaching skills.

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.

Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out our locations to learn more about our offices. All…