Director, Claims Process Optimization ( Facets Required)

Ladders; United States; Remote; USD 113,000 - 198,000; Full time

Benefits offered by this job

Comprehensive total rewards package

Focus on employee well-being

Opportunities for bonuses tied to perf

Collaborative workplace culture

Professional development opportunities

Job summary

Ladders in the United States is seeking a Director of Claims Process Optimization focused on Facets technology for remote, US-based candidates. The role drives automation and process improvement in claims operations, partnering with claims, operations, finance, and vendors to streamline workflows and optimize costs.

The ideal candidate will have 7+ years in health plan claims or healthcare operations, 5+ years in leadership, and a strong foundation in automation, data analytics, and financial

Qualifications

• Bachelor's degree in business, health administration, data analytics, or related field.
• 7+ years in health plan claims or healthcare operations.
• 5+ years in leadership roles.
• Practical understanding of automation and AI in claims work.
• Strong analytical and financial acumen.

Responsibilities

• Lead automation design and implementation within claims operations.
• Monitor and manage adjudication workflows and vendor performance.
• Develop and maintain the claims automation roadmap.
• Quantify benefit realization after implementation.
• Analyze claims workflows to identify constraints end-to-end.
• Build business cases for automation investments.
• Track cost per claim and inform staffing decisions.

Skills

Automation in claims

Data analytics

Financial acumen

AI in claims

Education

Bachelor's degree in business/health administration/data analytics

Job description

For our client, we are seeking a Director, Claims Process Optimization ( Facets Required) to join the team of a leader in the Finance & Insurance space.

This leader will shape claims operations strategy with a focus on process improvement, automation, and measurable operational outcomes. The role will partner closely with claims, operations, finance, and vendor stakeholders to streamline adjudication workflows and drive better efficiency across the organization. The successful candidate will translate workflow analysis into actionable automation investments, improved productivity, and stronger cost management.

Location: Remote - US based candidates only, no visa sponsorship available

Compensation: $113,000 - $197,700 annually

Responsibilities

• Lead the design and implementation of automation within claims operations
• Monitor and manage claims adjudication workflows and vendor performance
• Develop and maintain the claims automation roadmap
• Quantify benefit realization after implementation
• Conduct end-to-end analysis of claims workflows to identify constraints
• Build business cases for automation investments
• Track cost per claim and inform staffing decisions

Qualifications

• Bachelor's degree in business, health administration, data analytics, or a related field required
• 7 years of health plan claims or healthcare operations experience
• 5 years of leadership experience
• Practical understanding of automation and AI in claims work
• Strong analytical and financial acumen

Benefits

• Comprehensive total rewards package
• Focus on employee well-being
• Opportunities for bonuses tied to performance
• Collaborative workplace culture
• Professional development opportunities

Our client is an equal opportunity employer. We encourage you to apply even if you don't meet every qualification-your background could be exactly what this team needs.