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Health Plan Operations Jobs (NOW HIRING)

Intellivo

Attorney, Health Plan Recovery

Creve Coeur, MO · On-site

$100K - $120K/yr

Learn the intersection of healthcare, insurance, finance, ERISA, and legal operations * Commission ... Represent health plan recovery interests in discussions with plaintiff attorneys, carriers, and ...

Abilis Health Plan

Provider Network Manager

Memphis, TN · On-site +1

$70K - $80K/yr

Familiarity with health plan operations, including benefits, claims review and resolution, eligibility, provider data management, and network operations. * Knowledge of CMS network adequacy standards ...

HealthEdge

VP, Advisory Operations

$290K - $318K/yr

A Senior leader with deep expertise in health plan core administration technology and operations who leads advisory engagements assessing current-state of health plan technology and operations across ...

Abilis Health Plan

Provider Network Manager

Nashville, TN · On-site +1

$70K - $80K/yr

Familiarity with health plan operations, including benefits, claims review and resolution, eligibility, provider data management, and network operations. * Knowledge of CMS network adequacy standards ...

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Health Plan Operations information

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How much do health plan operations jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for health plan operations in the United States is $24.15, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $27.64 per hour, depending on experience, location, and employer.

What is health plan operations?

Health Plan Operations refer to the processes and activities involved in managing the daily functions of a health insurance plan. This includes tasks such as member enrollment, claims processing, provider network management, customer service, regulatory compliance, and quality assurance. Effective health plan operations ensure smooth delivery of healthcare benefits to members, maintain accurate records, and support financial and regulatory goals for the organization. These operations are crucial for delivering high-quality service and maintaining the trust of both providers and members.

What are the key skills and qualifications needed to thrive in health plan operations?

To excel in Health Plan Operations, a strong background in healthcare administration, data analysis, and regulatory compliance is essential, often supported by a bachelor's degree in healthcare management or a related field. Familiarity with claims processing systems, health information management software, and knowledge of HIPAA regulations are typically required. Exceptional organizational skills, attention to detail, and effective communication set high performers apart in this role. These skills ensure efficient health plan administration, regulatory adherence, and optimal service delivery to members and providers.

What are some common challenges faced in a health plan operations role, and how can new hires prepare to address them?

Professionals in Health Plan Operations often encounter challenges such as navigating complex regulatory requirements, managing cross-functional communication, and ensuring process efficiency while maintaining compliance. New hires can prepare by familiarizing themselves with relevant healthcare regulations (like HIPAA and ACA), developing strong organizational and analytical skills, and being proactive in collaborating with teams such as claims, provider relations, and IT. Building a solid understanding of internal procedures and fostering relationships across departments can help streamline workflows and address operational issues more effectively.

What is the difference between Health Plan Operations vs Claims Processor?

AspectHealth Plan OperationsClaims Processor
Primary RoleOversees overall health plan functions, including member services, provider relations, and complianceReviews and processes individual insurance claims for payment
Required CredentialsTypically requires knowledge of healthcare regulations, insurance policies, and sometimes certifications in health administrationOften requires familiarity with claims processing systems and basic insurance knowledge
Work EnvironmentOffice-based, collaborative teams, health insurance companies or managed care organizationsOffice or call center, focused on claims review and data entry

Health Plan Operations professionals manage the broader functions of health insurance plans, ensuring compliance and member satisfaction, while Claims Processors focus specifically on evaluating and processing insurance claims. Both roles are essential in the healthcare insurance industry but differ in scope and responsibilities.

What do you do in health plan operations?

Health plan operations professionals manage the daily functions of health insurance plans, including claims processing, member enrollment, provider network management, and compliance with healthcare regulations. They often use specialized software and require strong organizational and communication skills to ensure efficient plan administration.
More about Health Plan Operations jobs

What states have the most Health Plan Operations jobs?

States with the most job openings for Health Plan Operations jobs include:

Health Plan Operations jobs near you

Attorney, Health Plan Recovery

Creve Coeur, MO • On-site

Intellivo
See more jobs at Intellivoexternal

$100K - $120K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 9 days ago

Job description

Attorney, Health Plan Recovery

Launch your legal career where strategy drives measurable results.

Location: St. Louis, Missouri | On-site
Compensation: $100,000-$120,000 base salary plus uncapped performance incentive


Newly licensed and ready to build real negotiating experience? At Intellivo, you will own meaningful matters, work directly with attorneys and insurance carriers, and see how strong legal strategy translates into measurable financial outcomes for major health plans.


About the Role

Looking for a legal career that gives you work-life balance and uncapped commissions without the billable-hour model? As an Attorney in Health Plan Recovery, you will represent the reimbursement interests of some of the nation's largest health plans and resolve subrogation matters involving ERISA, non-ERISA, and fully insured plans.


You will develop negotiation strategy, communicate directly with plaintiff attorneys, carriers, and adjusters, and move matters from case positioning through settlement. Cases may involve motor vehicle accidents, premises liability, medical malpractice, and workers' compensation.


This is a business-focused legal role for attorneys who want to sharpen their judgment, advocacy, negotiation, and portfolio-management skills while producing visible client and financial impact.


Why Early-Career Attorneys Choose Intellivo

  • Build substantive negotiation experience from the start of your career
  • Fully own a large portfolio of cases and develop practical judgment through real decisions
  • Work directly with plaintiff attorneys, insurance carriers, adjusters, and experienced internal partners
  • Learn the intersection of healthcare, insurance, finance, ERISA, and legal operations
  • Commission success through case outcomes rather than billable hours
  • Grow into more complex matters, larger portfolios, and expanded leadership opportunities


What You'll Do

  • Manage a high-value portfolio of health plan reimbursement and subrogation matters
  • Represent health plan recovery interests in discussions with plaintiff attorneys, carriers, and adjusters
  • Evaluate liability, plan rights, settlement posture, reduction requests, escalation options, and recovery potential
  • Apply legal reasoning to matters involving ERISA, non-ERISA, and fully insured plans
  • Develop and execute negotiation strategy from case positioning through final settlement
  • Make timely recommendations and decisions that move matters toward resolution
  • Direct your legal assistants who support documentation, follow-up, and case administration within your portfolio
  • Maintain clear case strategy, documentation, and communication across a high-volume portfolio
  • Meet monthly settlement and recovery goals while delivering a consistent client experience


What Success Looks Like

  • You consistently deliver recovery results while protecting the health plan's reimbursement interests
  • You keep a high-volume portfolio moving and make strong decisions without unnecessary delay
  • You expand your impact over time through increased portfolio capacity and greater case complexity
  • You build confidence and sound judgment across increasingly complex recovery matters
  • You communicate persuasively, professionally, and directly with sophisticated external stakeholders


What You Bring

  • Juris Doctor degree from an accredited law school
  • Active license in good standing in at least one U.S. jurisdiction
  • 0-3 years of legal experience; relevant industry experience is welcome but not required
  • Strong written and verbal communication skills, with readiness to negotiate by phone and in writing
  • Critical thinking, sound judgment, and the ability to make timely decisions with available information
  • Ownership mindset and comfort being accountable for portfolio and financial outcomes
  • Ability to organize, prioritize, and progress multiple matters in a fast-paced environment
  • Drive to learn healthcare reimbursement, subrogation, insurance, and ERISA concepts
  • Collaborative, results-oriented approach with a focus on solutions and outcomes


No subrogation experience? That is okay. We will teach you the business. You bring your law license, curiosity, judgment, and drive to become a strong negotiator.


Compensation and Career Growth

  • Base salary: $100,000-$120,000, based on experience
  • Performance incentive: Uncapped commission tied directly to individual recovery outcomes
  • Total earnings: Uncapped and performance-driven
  • Growth path: Increased case complexity, portfolio ownership, earning opportunity, and leadership scope as capability and results grow


Great Fit for Attorneys Interested In

  • Negotiation and settlement strategy
  • Healthcare, insurance, ERISA, and financial services
  • Client advocacy without a traditional billable-hour model
  • Business-focused legal operations
  • Early ownership, measurable impact, and performance-based growth


Who is Intellivo?

As an industry market leader in subrogation, Intellivo empowers health plans and insurers to maximize financial outcomes by identifying and pursuing more reimbursement opportunities from alternative third-party liability (TPL) payers. Through innovative technology, Intellivo accelerates the identification of reimbursement opportunities while eliminating burdensome outreach to plan members. With a 26-year history of excellence, Intellivo proudly represents more than 200 of the country's largest health plans.


Benefits That Support You Inside and Outside of Work

  • Comprehensive medical, dental, and vision insurance
  • 401(k) retirement savings plan with employer match
  • Paid time off and paid holidays
  • Company-paid life insurance and short-term and long-term disability coverage
  • Employee Assistance Program with counseling, financial coaching, legal resources, career coaching, and wellness support
  • Health Savings Account with company contributions for eligible employees
  • Wellness, healthcare advocacy, and pet benefits
  • A high-performing, collaborative culture built on ownership, accountability, continuous improvement, and meaningful impact


Equal Opportunity Employer

Intellivo is an Equal Opportunity Employer and does not discriminate based on race, color, religion, sex, national origin, age, disability, or any other protected status. Employment decisions are based on qualifications, merit, and business need.

This is an on-site role in our St. Louis, Missouri office.


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