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Director Claims Operations Jobs (NOW HIRING)

Curative HR LLC

Sr. Director, Claims Operations

Austin, TX · On-site +1

$205K - $235K/yr

Role Overview The Sr. Director, Claims Operations is responsible for the end-to-end performance of the claims function, including adjudication accuracy, operational efficiency, compliance, vendor ...

Brookfield

Director, Claims Triage

Houston, TX

The Director, Claims Triage leads a nationwide triage operation, managing a fast-paced team responsible for the time sensitive intake and accurate routing of workers' compensation, liability, and ...

Brookfield

Director, Claims Triage

Los Angeles, CA · On-site

The Director, Claims Triage leads a nationwide triage operation, managing a fast-paced team responsible for the time sensitive intake and accurate routing of workers' compensation, liability, and ...

Brookfield

Director, Claims Triage

Richmond, VA · On-site

The Director, Claims Triage leads a nationwide triage operation, managing a fast-paced team responsible for the time sensitive intake and accurate routing of workers' compensation, liability, and ...

Brookfield

Director, Claims Triage

New York, NY · On-site

The Director, Claims Triage leads a nationwide triage operation, managing a fast-paced team responsible for the time sensitive intake and accurate routing of workers' compensation, liability, and ...

Brookfield

Director, Claims Triage

Albany, NY

The Director, Claims Triage leads a nationwide triage operation, managing a fast-paced team responsible for the time sensitive intake and accurate routing of workers' compensation, liability, and ...

Brookfield

Director, Claims Triage

Rockwood, PA · On-site

The Director, Claims Triage leads a nationwide triage operation, managing a fast-paced team responsible for the time sensitive intake and accurate routing of workers' compensation, liability, and ...

Brookfield

Director, Claims Triage

Chicago, IL · On-site

The Director, Claims Triage leads a nationwide triage operation, managing a fast-paced team responsible for the time sensitive intake and accurate routing of workers' compensation, liability, and ...

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$107.7K

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How much do director claims operations jobs pay per year?

As of Jun 8, 2026, the average yearly pay for director claims operations in the United States is $107,680.00, according to ZipRecruiter salary data. Most workers in this role earn between $75,500.00 and $135,500.00 per year, depending on experience, location, and employer.

What does a Director of Claims Operations do?

A Director of Claims Operations oversees the end-to-end claims process, ensuring efficiency, accuracy, and compliance with regulations. They develop and implement strategies to improve claims handling, manage team performance, and optimize workflow processes. Additionally, they collaborate with other departments to enhance customer service and minimize risk exposure. This role requires strong leadership, analytical skills, and knowledge of industry best practices.

What are the typical team dynamics and collaboration responsibilities for a Director Claims Operations?

As a Director Claims Operations, you’ll lead cross-functional teams of claims managers, adjusters, and support staff, often working closely with underwriters, legal, and compliance departments. Collaboration is key, as you’ll facilitate communication between departments to streamline claims handling, resolve complex cases, and implement process improvements. Directors frequently mentor team leaders, coordinate training efforts, and contribute to strategic initiatives that impact the overall claims workflow. This role offers the opportunity to influence company-wide insurance practices and can serve as a stepping stone to higher executive leadership positions within the organization.

What are the key skills and qualifications needed to thrive in the Director Claims Operations position, and why are they important?

Success as a Director Claims Operations requires strong leadership, in-depth knowledge of insurance claims processes, and a bachelor’s degree (often in business, insurance, or a related field), with many employers preferring advanced degrees or significant industry experience. Familiarity with claims management systems, data analysis tools, and regulatory compliance software, as well as certifications like AIC (Associate in Claims), are highly valued. Exceptional organizational, problem-solving, and interpersonal skills are critical for effectively managing teams and fostering cross-departmental collaboration. These competencies enable operational efficiency, ensure regulatory compliance, and help drive both customer satisfaction and financial performance within the organization.

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Director Claims Operations jobs near you

Sr. Director, Claims Operations

Curative HR LLC

Austin, TX • On-site, Remote

$205K - $235K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 26 days ago

Job description

About Curative
Curative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*. Backed by our recent $150M in Series B funding and valuation at $1.275B, Curative is scaling rapidly and investing in AI-powered service, deeper member engagement, and a smart network designed for today's workforce.
Our north star guides everything we do: healthcare only works when people can actually use it. That belief drives every decision we make: from how we design our plan, support our members, to how we collaborate as a team.
If you want to do meaningful work with a team that moves fast, experiments boldly, and cares deeply, Curative is the place to do it. We're growing fast and looking for teammates who want to help transform health insurance for the better.
Role Overview
The Sr. Director, Claims Operations is responsible for the end-to-end performance of the claims function, including adjudication accuracy, operational efficiency, compliance, vendor oversight, and technology optimization. This leader will partner across the organization to ensure claims operations support Curative's rapid growth and exceptional member and provider experience.
Key Responsibilities
Operational Leadership
  • Lead and scale end-to-end claims operations, including intake, adjudication, payment accuracy, and appeals coordination.
  • Establish performance standards and drive operational excellence across cycle time, cost per claim, accuracy, and productivity metrics.
  • Develop workforce planning models and resource strategies to support growth and changing claim volumes.
  • Build, mentor, and retain high-performing operational teams.
Claims Strategy & Transformation
  • Identify and implement automation, AI, and workflow optimization initiatives to improve scalability and operational efficiency.
  • Lead continuous improvement initiatives focused on reducing administrative costs and improving turnaround time.
  • Partner with technology teams to optimize claims platforms, configuration, and system integrations.
Data & Analytics
  • Leverage advanced analytics to monitor claims trends, identify operational gaps, and drive strategic improvements.
  • Develop dashboards and performance reporting to support executive decision-making.
  • Translate operational data into actionable insights that improve claim accuracy and cost management.
Quality & Compliance
  • Establish and oversee claims quality assurance and audit programs to ensure payment accuracy and regulatory compliance.
  • Serve as a key leader for state regulatory audits, compliance reviews, and market expansion readiness.
  • Ensure adherence to HIPAA, CMS requirements, and state regulations.
Cross-Functional Collaboration
  • Partner with internal stakeholders including Network, Utilization Management, Provider Operations, Member Services, Compliance, and Technology.
  • Act as a strategic liaison for complex provider or claims issues.
  • Lead cross-functional initiatives that improve provider experience and operational scalability.
  • Oversee third-party vendors and BPO relationships supporting claims operations.
  • Establish vendor performance standards and ensure alignment with operational KPIs and service level agreements.
Qualifications
Education
  • Bachelor's degree in Healthcare Administration, Business, Finance, or related field required
  • MBA or Master's degree in Healthcare Management, Analytics, or related field preferred
Experience
  • 10+ years of experience in health insurance claims operations
  • 7+ years of leadership experience managing large claims teams or multi-functional operations
  • Experience scaling employer group health plan operations
  • Demonstrated success leading claims transformation, automation, or process improvement initiatives
  • Experience managing claims vendors, BPO partnerships, or third-party administrators
  • Proven ability to build and lead high-performing operational teams
Expertise
  • Deep knowledge of health plan claims lifecycle, adjudication systems, and payment workflows
  • Strong understanding of payer regulatory frameworks, CMS requirements, and HIPAA compliance
  • Experience improving claims payment accuracy and operational cost structures
  • Expertise in operational metrics such as inventory management, productivity, quality scores, and cycle time
  • Preferred: Background implementing AI-enabled claims automation or advanced editing systems
  • Preferred: System integration / replacement while maintaining performance metrics
Technical Skills
  • Experience working with claims platforms (HealthEdge HealthRules Payer preferred)
  • Proficiency with data analytics tools and dashboards (Looker, Power BI, Snowflake, or similar)
  • Familiarity with automation, workflow optimization, and AI-driven operational tools
Leadership Competencies
  • Strategic thinker with the ability to balance operational execution and long-term transformation
  • Strong executive communication and stakeholder management skills
  • Proven ability to lead through change and scale operations in high-growth environments

Perks & Benefits
  • Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)
    • $0 copays and $0 deductibles (with completion of our Baseline Visit )
    • Preventive and primary care built in
    • Mental health support (Rula, Televero, Two Chairs, Recovery Unplugged)
    • One-on-one care navigation
    • Chronic condition programs (diabetes, weight, hypertension)
    • Maternity and family planning support
    • 24/7/365 Curative Telehealth
    • Pharmacy benefits
  • Comprehensive dental and vision coverage
  • Employer-provided life and disability coverage with additional supplemental options
  • Flexible spending accounts
  • Flexible work options: remote and in-person opportunities
  • Generous PTO policy plus 11 paid annual company holidays
  • 401K for full-time employees
  • Generous Up to 8-12 weeks paid parental leave, based on role eligibility.

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