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Director, Business Operations Support Enablement

Role overview

Qualifications

  • 8+ years of experience in operational excellence, process improvement, or direct operational management within complex environments
  • 3+ years of leadership experience managing complex, cross-functional programs or initiatives
  • Deep expertise in BPaaS operations, particularly within regulated healthcare environments
  • Bachelor’s degree or equivalent combination of education and demonstrated professional experience required; Lean Six Sigma and project management training preferred

Responsibilities

  • Lead end-to-end ownership and execution of process and technology improvement initiatives across Claims Adjudication BPaaS customers
  • Manage complex program planning and delivery, including timelines, resource allocation, and executive stakeholder communication
  • Conduct operational assessments and partner with functional leaders to identify inefficiencies and improvement opportunities
  • Develop clear requirements focused on desired business outcomes for customer requested changes and strategic initiatives

Key facts

Other skills

  • Program Management
  • Communication
  • Team Leadership
  • Analytical Skills
  • Mentorship

About the company

HealthEdge logo

HealthEdge

Digital Health & Health Tech

HealthEdge is on a mission to drive a digital transformation in healthcare. We’re connecting health plans, providers, and patients with end-to-end digital technology solutions to support new business models, reduce administrative costs and improve health outcomes. Our growing portfolio of products (HealthRules® Payer, Source, GuidingCare, and Wellframe) provides talented and passionate professionals with opportunities to lead change and make a lasting, global impact in healthcare. Driving our mission are 2,000+ professionals worldwide. Together, we are committed to innovating a world where healthcare can focus on people.

Company details

IndustryDigital Health & Health Tech
Company size1001 - 5000

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Job description

Overview:

HealthEdge is seeking a Director – Business Operations Support-Enrollment (Director I/II – Operations) to lead and scale a team within our Operations Enable and Governance function. The Director will own and drive the execution of Customer and Organizational Improvement initiatives within and across BPaaS Claims operations. This role is responsible for managing complex, cross-functional initiatives across multiple client accounts, delivering measurable and sustained improvements in cost, quality, and efficiency, and partnering with the Operations leadership team.

 

Key Responsibilities

  • Lead end-to-end ownership and execution of process and technology improvement initiatives across Claims Adjudication BPaaS customers.
  • Own operational excellence delivery across a portfolio of BPaaS client accounts, balancing performance, risk, and value realization at scale.
  • Manage complex program planning and delivery, including timelines, resource allocation, risk management, and executive stakeholder communication.
  • Conduct operational assessments and partner with functional leaders to identify inefficiencies, scalability constraints, and improvement opportunities.
  • Develop clear requirements focused on desired business outcomes for customer requested changes and other strategic initiatives.
  • Perform root cause analysis and develop actionable recommendations for process optimization and measurable performance improvement.
  • Document work instructions and plan training programs to support Operations enablement and change management.
  • Develop and maintain program dashboards to track KPIs, cost savings, efficiency gains, and transformation outcomes for tracking.
  • Coordinate cross-functional teams to implement process improvements, automation, and workflow optimization at scale.
  • Ensure standardization and scalable adoption of processes and best practices across customer accounts.
  • Collaborate with technology teams to support and enable automation initiatives (RPA, AI/ML).
  • Lead change management efforts to ensure adoption, sustainability, and long-term value realization of improvements.
  • Facilitate governance processes, including executive review cadences and escalation protocols.
  • Communicate program progress, risks, and outcomes to executive stakeholders and client leadership.
  • Mentor and develop team members, building future operational leaders within the operational excellence function.

Qualifications

  • 8+ years of experience in operational excellence, process improvement, or direct operational management within complex, multi-client, and/or enterprise service environments. 3+ years of leadership experience managing complex, cross-functional programs or initiatives with executive-level visibility.
  • Deep expertise in BPaaS operations, particularly within regulated healthcare environments including enrollment, claims processing, and contact center operations.
  • Proven ability to deliver measurable and sustained improvements in cost, quality, efficiency, and operational performance at scale.
  • Excellent program management, analytical, and executive stakeholder engagement skills.
  • Bachelor’s degree or equivalent combination of education and demonstrated professional experience required; Lean Six Sigma and project management training, or demonstrated hands-on leadership of large-scale process improvement programs, strongly preferred

Geographic Responsibility:  Remote, US

Type of Employment: Full-time, permanent 

FLSA Classification (USA Only): Exempt 

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  

  • The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  
  • Work across multiple time zones in a hybrid or remote work environment. 
  • Long periods of time sitting and/or standing in front of a computer using video technology. 
  • May require travel dependent on company needs. 

 

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.  Candidates may be required to go through a pre-employment criminal background check. 

 

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. 

#LI-Remote 

**The annual US base salary range for this position is $189,000 to $205,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.  

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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