Manager, Operations Automation – Strategy

Job not on LinkedIn

🔥 5 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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Availity

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2000

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Secondary Market on 2021-07

Healthcare • Consulting • Logistics

Availity is a leading health information network that connects payers, providers, and technology partners in the healthcare industry. By facilitating over 13 billion clinical, administrative, and financial transactions annually, Availity streamlines payer-provider collaboration and enhances patient care through an integrated provider engagement platform. The company's solutions leverage artificial intelligence and interoperability to automate processes such as prior authorizations, revenue cycle management, and payment accuracy, ultimately reducing costs and improving efficiency across the healthcare ecosystem.

📋 Description

• Lead and develop a team of analysts and operational specialists • Establish performance goals, monitor operational metrics, and provide coaching and professional development • Foster 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 • Identify operational risks, recurring response gaps, processing trends, and payer-specific issues • Lead 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 • Track, communicate, and resolve known issues and operational risks • Identify, prioritize, and implement automation opportunities • Partner with Product and Engineering to develop automated workflows, monitoring solutions, dashboards, and reporting capabilities • Evaluate processes for standardization, simplification, and continuous improvement • Define business requirements, success metrics, and operational controls for automation initiatives • Measure and report automation outcomes, including reductions in manual effort, processing time, and operational risk • Translate operational challenges into scalable solutions and strategic initiatives • Communicate operational health, risks, trends, and improvement opportunities to leadership • Support operational planning, capacity management, and service delivery strategies • Recommend operational priorities, process improvements, monitoring capabilities, and technology investments

🎯 Requirements

• 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 and payer operations • 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 • Preferred: knowledge of EDI transactions, including 837, 835, 277CA, and HIPAA X12 standards • Preferred: familiarity with Jira, ServiceNow, Salesforce, dashboard development, workflow automation, reporting tools, and operational analytics • Preferred: experience defining requirements for automated workflows, alerts, monitoring solutions, and exception management • Must be able to use a camera for all virtual meetings • Must pass a drug test before beginning employment • Must meet U.S. employment eligibility verification requirements • Sponsorship, in any form, is not available for this position

🏖️ Benefits

• Competitive salary • Bonus structure • HSA company contribution • Healthcare benefits • Vision benefits • Dental benefits • 401k match program available on day one • Unlimited PTO for salaried associates • 9 paid holidays • Wellness reimbursement up to $250/year for gym memberships, racing events, weight management programs, etc. • Education reimbursement • Paid Parental Leave for birth parents and adoptive parents • Diversity & Inclusion teams and employee groups • Continuous learning resources and industry/technology experts • Camera/video capability for remote work • Community volunteering opportunities