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Rx.Health (Commure Engage) · 4 months ago

Senior Operations Manager, Healthcare Billing/Denials Operations

Mountain View, CA

Full-time

Onsite

Mid, Senior Level

$120K/yr - $150K/yr

4+ years exp

Commure is a company on a mission to simplify healthcare through innovative AI solutions. The Senior Operations Manager will lead strategic initiatives focused on denials management and claims optimization, driving operational improvements and collaborating with cross-functional teams to enhance revenue capture.

Health CareHealth InsuranceHospitalLife Science

Responsibilities

Lead Denials Management Strategy: Oversee the claims lifecycle from post-submission to resolution, with an emphasis on denial trends. Design and implement scalable solutions that reduce friction and revenue loss

Drive Root Cause Analysis: Investigate systemic issues behind rejections and denials using structured analysis, and implement preventative solutions to improve operational efficiency

Own Key Operational Metrics: Manage throughput, denial rates, and other key metrics for high-profile client accounts. Use data to surface insights and drive continuous improvement

Build and Scale Processes: Design repeatable, automated workflows that enable operational scale and reduce manual effort. Collaborate with product and engineering to define requirements for internal tooling

Client Partnership: Serve as a subject matter expert for critical accounts. Partner with account managers and clients to troubleshoot issues and implement operational improvements

Qualification

Healthcare operationsRevenue cycle managementData analysisSQLOperational leadershipCommunicatorBias for actionSystems thinkerOwnership mindset

Required

4+ years of relevant experience in healthcare operations, revenue cycle management, healthcare consulting, or related roles

Experience in high-growth or tech-enabled healthcare environments is a strong plus

Strong analytical skills, with the ability to independently perform data analysis (Excel required; SQL strongly preferred)

Operational leadership experience with a track record of managing cross-functional initiatives and improving process performance at scale

Systems thinker: You naturally zoom out to see patterns and zoom in to identify root causes

Ownership mindset: You hold yourself and others to high standards and take accountability for results, not just tasks

Excellent communicator: You translate complexity into clarity—for both internal stakeholders and external clients

Bias for action: You thrive in fast-paced environments and are comfortable navigating ambiguity and evolving priorities

Company

Rx.Health (Commure Engage)

𝐖𝐞’𝐫𝐞 𝐞𝐱𝐜𝐢𝐭𝐞𝐝 𝐭𝐨 𝐬𝐡𝐚𝐫𝐞 𝐭𝐡𝐚𝐭 𝐑𝐱.𝐇𝐞𝐚𝐥𝐭𝐡 𝐢𝐬 𝐧𝐨𝐰 𝐩𝐚𝐫𝐭 𝐨𝐟 𝐂𝐨𝐦𝐦𝐮𝐫𝐞 𝐄𝐧𝐠𝐚𝐠𝐞, 𝐞𝐱𝐩𝐚𝐧𝐝𝐢𝐧𝐠 𝐨𝐮𝐫 𝐜𝐚𝐩𝐚𝐛𝐢𝐥𝐢𝐭𝐢𝐞𝐬 𝐚𝐧𝐝 𝐫𝐞𝐚𝐜𝐡!! After impacting over 30 million lives across leading health systems and supporting more than 60 million members through UnitedHealthcare, our team and resources have grown significantly to better serve providers, payers, and patients worldwide.

Founded in 2017

New York, New York, USA

11-50 employees