Senior Operations Optimization Specialist

EmblemHealth; New York (NY); On-site; USD 68,000 - 119,000; Full time

Job summary

EmblemHealth in New York, NY seeks an operations program lead to drive end-to-end improvements across Claims, Provider Operations, Enrollment, Billing, and Call Center functions.

You will translate business needs into structured work plans, engage stakeholders, and deliver measurable operational outcomes with minimal oversight. The role emphasizes data analysis, process mapping, and cross-functional collaboration.

Qualifications

• Bachelor’s degree required.
• 4–6+ years in healthcare payer operations or related consulting.
• Experience leading cross-functional process improvement initiatives.

Responsibilities

• Drive end-to-end initiatives from intake to completion across Operations.
• Define scope, milestones, deliverables, risks, and dependencies.
• Develop execution plans using Excel, MS Project, Smartsheet, or Agile tools.
• Lead stakeholder sessions and resolve issues to progress initiatives.
• Analyze processes across Claims, Enrollment, Call Center, and Appeals.
• Translate needs into requirements and support system/workflow changes.

Skills

Healthcare payer operations

Process improvement

Cross-functional collaboration

Data analysis

Project management

MS Office

Agile tools (Jira/Azure DevOps)

Stakeholder engagement

Education

Bachelor's Degree

Tools

MS Project

Smartsheet

Visio

Jira

Azure DevOps

Job description

EmblemHealth in New York, NY seeks an operations program lead to drive end-to-end improvements across Claims, Provider Operations, Enrollment, Billing, and Call Center functions.

You will translate business needs into structured work plans, engage stakeholders, and deliver measurable operational outcomes with minimal oversight. The role emphasizes data analysis, process mapping, and cross-functional collaboration.