Rockefeller Philanthropy Advisors seeks a Director of Claim Operations & Transformation to lead our entire claims processing operation. You will ensure accuracy, efficiency, and strict compliance with prompt pay regulations. You’ll drive operational excellence by managing workflows, optimizing team performance, and fostering a culture focused on quality and accountability, while collaborating with product and engineering teams to automate processes.
What You'll Do
- Manage claim processing inventory and queue oversight, ensuring timely completion within prompt pay timelines.
- Investigate prompt pay misses and develop systems to prevent future occurrences.
- Build and enhance quality management processes using team feedback and claims data.
- Develop capacity models to forecast volume, identify hiring needs, and ensure training adequacy.
- Track and report impacts of operational and technical changes on efficiency and accuracy.
- Translate organizational goals into actionable programs and team initiatives.
- Identify opportunities to leverage automation, AI, and modern tools to reduce manual tasks.
- Collaborate with product and engineering teams to develop tools that mitigate operational risks.
- Promote transparency and teamwork while cultivating a culture of accountability and professional growth.
What We're Looking For
- 7+ years of operations leadership experience.
- Proven track record managing large processing teams in fast-paced, deadline-driven environments.
- Experience working with product and engineering teams on automation and tool development.
- Comfortable with AI, workflow tools, and modern process improvement methodologies.
- Strong analytical skills with expertise in operational forecasting and capacity planning.
- Demonstrated ability to build and lead high-performing, accountable teams focused on continuous improvement.
- Exceptional communication skills emphasizing transparency, clarity, and collaboration.
- Bachelor's degree required.
Nice to Have
- Preferably within healthcare claims or revenue cycle.
- Advanced degree preferred.
Technical Stack
- AI
- Workflow tools
Team & Environment
You will lead large processing teams within a mission-driven organization that cultivates a culture of accountability and professional growth.
Benefits & Compensation
- Competitive salary, bonus potential, and equity package.
- Comprehensive medical, dental, and vision insurance.
- 401(k) retirement plan.
- Paid vacation, company holidays, and recharge days.
- Opportunity to contribute to a rapidly growing, mission-driven company revolutionizing healthcare.
Work Mode
This is a remote position open to candidates located anywhere in the United States.
Rockefeller Philanthropy Advisors is an equal opportunity employer.
