Senior Learning Operations Manager
SAE International
Healthcare TPA Operations Manager
General Dynamics Information Technology
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $116,450 - $157,550 per year
Job Level
SeniorLead
Tech Stack
Tableau
About the role
- Plan, establish, execute, control, and optimize administrative healthcare business operations associated with a limited public health plan
- Oversee day-to-day operations of federal Health Program TPA activities, ensuring efficient service delivery and compliance with CMS and federal standards
- Ensure all operations related to Member and Provider Enrollment, Credentialing, Claims Administration, and Payments are delivered in accordance with SLAs and QASP metrics
- Drive delivery of business outcomes with the highest quality of care, equity, and stakeholder satisfaction
- Develop, implement, and monitor operational policies, SOPs, and performance dashboards to continuously improve service quality and program results
- Coordinate across clinical centers, administrative teams, vendors, and federal stakeholders to ensure seamless execution of program activities
- Manage budgets, resource allocation, workload distribution, and operational priorities to meet deadlines and ensure fiscal responsibility
- Monitor performance data, prepare leadership reports, and identify trends, risks, compliance issues, and opportunities for continuous improvement
- Oversee vendor and contractor performance, ensuring adherence to contractual obligations, SLAs, and compliance with HIPAA, and program requirements
- Lead operational readiness for new regulations, policies, services, and technology implementations, including change management and training
- Serve as a primary point of contact for escalated issues, member grievances, and provider concerns, driving timely resolution and root-cause analysis
- Manage a large team
Requirements
- Bachelor’s degree in healthcare administration, Public Health, Business Administration, or related field (Master’s preferred)
- 7–10+ years in healthcare operations management, with at least 3–5 years in federal or public sector health programs (Medicaid, Medicare, VA, DoD, or CDC/NIOSH programs)
- Strong knowledge of healthcare delivery systems, managed care operations, claims processing, and quality improvement methodologies
- Experience leading large-scale operations in a TPA, Medicaid Enterprise System (MES), or public health program
- Demonstrated success in managing budgets, contracts, SLAs, and performance metrics in a regulated environment
- Skilled in vendor/contractor oversight, procurement processes, and performance-based vendor management
- Strong understanding of healthcare regulations (HIPAA, ACA, Medicaid/Medicare rules, CMS QASP, NIST/FedRAMP security)
- Proficiency with healthcare management systems (provider enrollment systems, claims adjudication systems) and data analytics tools (Power BI, Tableau, etc.)
- Experience managing a large team
- Ability to obtain and maintain a Public Trust
Benefits
- Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts
- Dental plan options
- Vision plan
- 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match
- Full flex work weeks where possible
- A variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave
- 15 days of paid leave per calendar year
- An additional 10 paid holidays per year
- GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees
- Short and long-term disability benefits
- Life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
healthcare operations managementclaims processingquality improvement methodologiesvendor managementbudget managementcontract managementperformance metricsdata analyticshealthcare delivery systemspublic health program management
Soft skills
leadershipcommunicationproblem-solvingteam managementstakeholder engagementchange managementroot-cause analysisorganizational skillsperformance monitoringservice quality improvement
Certifications
Bachelor’s degree in healthcare administrationMaster’s degree in healthcare administration (preferred)Public Trust certification
