Sr. Director, Claims Pricing
Core
Leads strategic initiatives to improve the performance, efficiency, scalability, and future readiness of the Claims Pricing & Revenue organization within the healthcare financial services sector.
Role type
Sr. Director, Claims Pricing & Revenue Operations
Builds
Modernized claims pricing, repricing, negotiation, and revenue operations workflows for healthcare payers and providers.
Domain
Healthcare / Insurance / Revenue Operations
Deliverable
product features
Required skills
Strategic planning, cross-functional leadership, operational transformation, AI and automation strategy, process optimization, financial analysis, stakeholder management, change management, data-driven decision making, client escalation management
Preferred skills
Experience with globalization strategies, AI implementation, workflow standardization, capacity modeling
Technologies
AI tools, automation platforms, analytics dashboards
Responsibilities
Translate business priorities into actionable roadmaps and measurable outcomes; identify and implement AI, automation, and workflow opportunities to improve productivity and cost-to-serve; optimize end-to-end claims pricing, repricing, and negotiation processes; define KPIs and establish feedback loops for operational performance; lead complex cross-functional initiatives without direct reporting authority; resolve high-impact client escalations.
Seniority
Senior Director, strategic leadership & cross-functional influence