Manager, Operations Automation & Strategy

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change. At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare!

With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission. We're on a mission to bring the focus back to what truly matters - patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions.

With over 2 million providers connected to health plans, and processing over 13 billion transactions annually, our influence is continually expanding. Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem.

The Manager, Operations Automation & Strategy is responsible for leading teams that support health plan and provider service delivery through operational excellence, workflow optimization, automation, and systems monitoring. This role oversees the Missing Claim Response process, operational triage and escalation management, and known issue governance to ensure timely resolution of operational risks and service disruptions. The Manager drives continuous improvement initiatives that enhance operational efficiency, strengthen monitoring capabilities, reduce manual effort, and improve scalability.

Serving as a key liaison between Operations, Product, Engineering, Account Management, Client Success, and health plan stakeholders, this role promotes service stability, clear ownership, and data-driven decision making across critical operational workflows.

Sponsorship, in any form, is not available for this position.

Location:

Remote, US

• Required Bachelor's degree
• Five or more years of experience in healthcare payer operations
• Three or more years of leadership experience managing operational, systems, analytical, or technical teams.
• Strong understanding of healthcare claims processing, payer operations, Demonstrated ability to identify process improvement and automation opportunities and translate operational needs into actionable requirements.
• Experience managing cross-functional relationships with Product, Engineering, Operations, Client Services, Account Management, and other stakeholders.
• Strong analytical, problem-solving, organizational, and decision-making skills.
• Excellent written and verbal communication skills, with the ability to communicate complex operational and technical information clearly.
• Preferred Experience managing configuration-driven solutions, transaction monitoring, or healthcare transaction workflows.
• Knowledge of EDI transactions, including the 837, 835, 277CA, and HIPAA X12 standards.
• Familiarity with Jira, Service Now, salesforce, dashboard development, workflow automation, reporting tools, and operational analytics.
• Experience defining requirements for automated workflows, alerts, monitoring solutions, and exception management.

• Lead and develop a team of analysts and operational specialists.
• Establish performance goals, monitor operational metrics, and provide coaching and professional development.
• Foster a culture of accountability, collaboration, innovation, and continuous improvement.
• Ensure clear responsibilities, escalation paths, and service expectations across the team.

• Oversee the Missing Claim Response workflow, including monitoring, investigation, escalation, and resolution activities.
• Identify operational risks, recurring response gaps, processing trends, and payer-specific issues.
• Lead the intake, triage, prioritization, and routing of operational tickets, known issues, and support requests.
• Establish workflow standards and governance to improve efficiency and reduce delays, duplicate work, and unclear ownership.
• Ensure timely resolution of production issues, client escalations, and operational support requests.
• Lead the identification, tracking,…