Senior Manager, Quality Audit

HealthEdge

Group Manager, Business Operations at UST HealthProof, leading strategies in health insurance operations. Focus on enhancing business performance and compliance for customer needs.

Posted 7/2/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $155,000 - $165,000 per yearWebsite

About the role

Key responsibilities & impact

Plan, develop, organize, direct and evaluate all aspects of onshore and offshore BPaaS activities
Serve alongside multiple stakeholders, including Configuration, IT Operations, Contact Center Operations, and Medical Management to deliver customer success
Establish operational objectives, policies and procedures ensuring compliance with customer contracts and related laws and regulations
Develop and execute strategies to achieve key performance measures
Identify, recommend, and implement new processes, technologies, and systems to improve and streamline processes and use of resources
Establish and administer the department budget
Provide Executive level briefings to Senior Leadership at regular intervals to keep leadership current with updates and performance levels
Establish strong, collaborative relationships with client leadership

Requirements

What you’ll need

Bachelor’s Degree in Business, Health Services Administration, or related field
A minimum of 8 years of progressive management experience in health plan operations, with a strong understanding of claims processing
5 – 7 years Medicare Advantage experience preferred

Benefits

Comp & perks

Health insurance
Paid time off
Flexible work arrangements
Professional development

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Operational Strategy DevelopmentPerformance MeasurementProcess ImprovementPolicy and Procedure EstablishmentResource Utilization

Soft Skills

LeadershipCollaborationCommunication