Directs the day-to-day management of operational work queues including operational intake, complex claims processing, provider dispute resolution (PDR), encounter operations, adjustments and reprocessing, member reimbursements, correspondence management, check run operations, and other assigned operational functions. • Minimum eight (8) years of progressively responsible experience in managed care claims operations, including leadership responsibility for claims processing, operational management, provider dispute resolution, encounter operations, payment operations, or related healthcare administrative functions.