Senior Manager, Strategic Claims & Negotiations

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

Benefits offered by this job

401k with employer match

Paid time off

Holiday policy

Parental leave

Health, dental, vision insurance

Job summary

Zelis Healthcare, LLC is seeking a senior leader to oversee multiple negotiation teams within the claims function, driving operational excellence and strategic initiatives while ensuring regulatory compliance. The role collaborates with senior leadership to set goals, monitor performance, and improve processes for better customer outcomes.

Ideal candidates have extensive leadership experience, proficiency with AI-enabled tools, and a proven ability to guide complex negotiations and data-driven

Qualifications

• Bachelor's degree with extensive experience (12+ years) or Master's with 8+ years in leadership roles.
• Proficiency using AI tools to develop 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.

Responsibilities

• Lead and manage multiple negotiator teams, aligned with organizational goals.
• Develop and implement departmental strategies to optimize claims resolution outcomes.
• Oversee high-value and complex claims negotiations, providing guidance 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 relationships with internal and external stakeholders.
• Ensure compliance with regulatory requirements and company standards.
• Provide training, support, and development opportunities to teams.
• Conduct regular performance reviews and provide growth feedback.

Skills

Team leadership

AI tools proficiency

Cross-functional collaboration

Strategic thinking

Stakeholder influence

Education

Bachelor's degree

Master's degree

Tools

AI tools

Job description

Zelis Healthcare, LLC is seeking a senior leader to oversee multiple negotiation teams within the claims function, driving operational excellence and strategic initiatives while ensuring regulatory compliance. The role collaborates with senior leadership to set goals, monitor performance, and improve processes for better customer outcomes.

Ideal candidates have extensive leadership experience, proficiency with AI-enabled tools, and a proven ability to guide complex negotiations and data-driven