Manager,Digital Claims Optimization Job Mountlake Terrace area,Washington USA,IT/Tech

Help redefine how claims work gets done—at scale and with purpose.
Lead the design and operational delivery of automation and AI-enabled workflow solutions that replace manual, repetitive work with reliable digital decisioning.
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.
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 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.

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.

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Manager, Digital Claims Optimization