Senior Manager, State Arbitration

Zelis Healthcare, LLC; Morris Township (NJ); Hybrid; USD 95,000 - 121,000; Full time

Job summary

Zelis Healthcare, LLC is actively seeking a senior leader to oversee multiple teams in the claims negotiation function. The role focuses on operational excellence, strategic initiatives, and strict compliance across claims processes, partnering with leadership to set goals and drive improvement.

You will manage high-value negotiations, monitor metrics, and guide policy development while mentoring staff to achieve high performance and customer satisfaction.

Qualifications

• Typically has a Bachelor's degree with 12+ years of experience; a Master's adds 8+ years.
• Requires proficiency using AI tools skillfully with prompt/agent development ability.
• Experience leading multiple teams or large-scale projects.
• Strong strategic thinking and execution capabilities.

Responsibilities

• Lead and manage multiple teams of negotiators, ensuring alignment with organizational objectives.
• Develop and implement departmental strategies to optimize claims resolution outcomes.
• Oversee high-value and complex claims negotiations, providing guidance and approval as needed.
• Monitor performance metrics and drive continuous improvement initiatives.
• Collaborate with senior leadership to establish policies, procedures, and best practices.
• Analyze claims data to identify trends and recommend strategic improvements.
• Build and maintain strong relationships with internal and external stakeholders.
• Ensure compliance with regulatory requirements and company standards.
• Provide training, support, and development opportunities to team members to ensure high performance and engagement.
• Conduct regular performance reviews, provide feedback, and identify opportunities for professional development.

Skills

AI tools proficiency

Leadership experience

Strategic thinking

Cross-functional influence

Coaching skills

Education

Bachelor's degree

Master's degree

Job description

At Zelis, we Get Stuff Done. So, let's get to it!

A Little About Us

Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients.

At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

A Little About You

You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

Position Overview

This role is responsible for overseeing multiple teams or a large, complex team within the claims negotiation function. This role focuses on driving operational excellence, implementing strategic initiatives, and ensuring compliance across all claims processes. This role partners with leadership to set goals, monitor performance, and lead process improvement efforts that enhance efficiency and customer satisfaction.

What You'll Do:

• Lead and manage multiple teams of negotiators, ensuring alignment with organizational objectives.
• Develop and implement departmental strategies to optimize claims resolution outcomes.
• Oversee high-value and complex claims negotiations, providing guidance and approval as needed.
• Monitor performance metrics and drive continuous improvement initiatives.
• Collaborate with senior leadership to establish policies, procedures, and best practices.
• Analyze claims data to identify trends and recommend strategic improvements.
• Build and maintain strong relationships with internal and external stakeholders.
• Ensure compliance with regulatory requirements and company standards.
• Provide training, support, and development opportunities to team members to ensure high performance and engagement.
• Conduct regular performance reviews, provide feedback, and identify opportunities for professional development.

What You'll Bring to Zelis:

• Typically has Bach. +12 yrs.; Masters +8 yrs. Attends company training and regional training in area of expertise. Presents own work to members of department and external consultants and external professional conferences, Collaborates externally, Hosts external guests, visitors and consultants
• Requires proficiency using AI tools skillfully with an understanding of how to develop/create intelligent prompts and/or agents.
• Experience leading multiple teams or large-scale projects.
• Strong strategic thinking and execution capabilities.
• Ability to influence cross-functional stakeholders and drive alignment.
• Advanced leadership and coaching skills.

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.

Location and Workplace Flexibility

Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out our locations to learn more about our offices. All employee work locations are based on the needs of the position and are determined by the Leadership team. In-office work and activities vary based on work and team objectives in accordance with Company policies.

While location expectations vary by role, candidates within approximately 50 miles of a U.S. office are generally preferred to support collaboration when needed. Our hybrid approach is flexible, and in-office presence is guided by team and business needs rather than a fixed weekly schedule.

Base Salary Range

$95,000.00 - $120,650.00

At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role.

Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.

Equal Employment Opportunity

Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email [e-mail].

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.