Sr. Manager, Operational Excellence

Senior Manager, Operational Excellence

Remote Position

About the Role

Intellivo is seeking a Senior Manager of Operational Excellence with direct experience in healthcare billing, subrogation, or health insurance operations. This experience is required.

Reporting to the Senior Director of Operational Excellence, this role helps ensure that the processes supporting healthcare claim identification, case development, and recovery are followed consistently and working as intended.

You will use established KPIs and operational reviews to identify breakdowns in performance or process adherence, diagnose the root cause, and coordinate process and technology issues through resolution. You will also perform UAT for system defects, bug fixes, and workflow changes affecting Intellivo’s recovery operations.

This is a hands-on player-coach role requiring healthcare operational knowledge, analytical thinking, process discipline, technology fluency, strong follow-through, and the ability to lead and develop a small team of 5–7 employees.

What You’ll Do

Monitor Operational Adherence

• Evaluate whether established case workflows, processes, and operating standards are followed consistently.
• Use established KPIs and performance signals to identify areas requiring investigation.
• Review operational activity across the healthcare claims and recovery lifecycle to identify breakdowns, inconsistencies, rework, delays, or unintended outcomes.
• Partner and provide Recovery Operations leadership with clear, evidence-based findings when issues involve employee adherence, knowledge, training, or performance.

• Drive employee adoption of new processes and procedures and monitor adherence following implementation.

Diagnose Root Cause

• Investigate operational and performance issues to determine the underlying cause.
• Determine whether issues stem from process adherence, process design, workflow, technology, automation, data, capacity, or another operational factor.
• Analyze case activity, operational data, and workflow behavior to validate findings.
• Distinguish between issues requiring process or technology remediation and those requiring intervention by Recovery Operations leadership.
• Translate findings into clear recommendations and required outcomes.

Manage Process & Technology Resolution

• Coordinate process, workflow, system, or automation changes needed to resolve identified issues.
• Define business requirements, ownership, expected outcomes, and measures of successful resolution.
• Work across Recovery Operations, Technology, Product, Finance, Legal, and Client Services to move issues through resolution.
• Track issues, dependencies, and solutions through completion.
• Validate results after implementation to confirm the underlying issue has been resolved.

Perform UAT & Validate Fixes

• Coordinate and perform UAT for bug fixes, system changes, automation, and operational workflow improvements.
• Develop test scenarios based on healthcare claims, case management, and recovery workflows.
• Validate that system changes address the original operational issue without creating unintended downstream impacts.
• Document testing results, defects, and unresolved issues.
• Maintain follow-through from issue identification through testing, deployment, and post-implementation validation.

Required Qualifications

• 8+ years of direct professional experience in healthcare billing or health insurance operations is required. Candidates without this experience will not be considered.
• 3+ years people management
• Experience working with healthcare claims, billing, reimbursement, revenue cycle, payment integrity, subrogation, coordination of benefits, recovery, or related insurance workflows.
• Demonstrated ability to investigate healthcare operational issues and identify root causes across people adherence, process, workflow, technology, and data.
• Experience performing UAT for system defects, bug fixes, workflow changes, and technology implementations.
• Experience translating operational issues into clear business requirements and test scenarios.
• Strong analytical skills and working knowledge of AI prompting, Power BI and Excel.

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 & 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
• 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

Originally posted on Himalayas