Manager, Digital Claims Operations

Premera Blue Cross Premera Blue Cross · Insurance · WA Mountlake Terrace Orcas

Manager for Digital Claims Operations responsible for leading the design and operational delivery of automation and AI-enabled workflow solutions. This role focuses on replacing manual work with digital decisioning, partnering with Product and Technology to build automations, performance dashboards, and data-driven improvements. The role involves hands-on leadership in transforming claims operations through scalable automation solutions and system enhancements, owning the end-to-end delivery from process analysis to adoption.

What you'd actually do

  1. Drive the digitization and automation of priority Claims Operations workflows—using process automation and AI-enabled decisioning—to improve cycle time, accuracy, and customer experience.
  2. Design scalable, well-controlled automated workflows and decision paths that are aligned to operational needs and enterprise claims strategy.
  3. Build and maintain dashboards and operational reporting to measure workflow performance, automation effectiveness, and post-implementation outcomes.
  4. Use data to identify bottlenecks and continuously optimize workflows through targeted automation and process improvements.
  5. Own end-to-end delivery for claims automation and operational change (requirements, testing/UAT coordination, defect management, readiness sign-off, and implementation).

Skills

Required

  • Bachelor’s degree in a technical or quantitative field or 4 years of relevant experience
  • 5 years of experience in digitizing and automating operational workflows, or application development in a business environment, or data analysis and business intelligence reporting
  • 2 years of hands‑on experience in data analysis and reporting, including building and using dashboards and operational reports
  • 3 years of management experience, including accountability for delivery quality, team development, and leading teams through change

Nice to have

  • Experience scaling automation across multiple workflows or operational areas using repeatable delivery patterns.
  • Familiarity with claims operations or similar process‑driven domains.
  • Experience building dashboards and operational reporting using Power BI, Tableau, or equivalent BI tools.
  • Familiarity with SDLC practices and backlog or ticketing tools.
  • Practical application of continuous improvement methods within automated operations.
  • Demonstrated ability to operate at the intersection of business and technology, translating system or automation changes into practical, operational outcomes.

What the JD emphasized

  • AI-enabled workflow solutions
  • automation and AI-enabled decisioning
  • build well-controlled process automations
  • data-driven improvements
  • operational delivery of automation initiatives
  • hands-on leadership role
  • solving complex operational problems
  • smart use of technology
  • scalable automation solutions
  • systems thinking
  • data-driven mindset
  • hands-on solution development
  • digitizing and automating operational workflows
  • Application development in a business environment
  • Data analysis and business intelligence reporting
  • building and using dashboards and operational reports
  • scaling automation across multiple workflows
  • claims operations or similar process‑driven domains
  • building dashboards and operational reporting
  • SDLC practices
  • backlog or ticketing tools
  • continuous improvement methods within automated operations
  • operate at the intersection of business and technology

Other signals

  • AI-enabled workflow solutions
  • automation and AI-enabled decisioning
  • build well-controlled process automations
  • data-driven improvements
  • operational delivery of automation initiatives