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Zelis is modernizing healthcare financial experiences across payers, providers, and consumers, serving 750+ payers including the top five national health plans and millions of providers. This Manager role leads operational performance, quality, compliance, and workforce strategy for Federal Independent Dispute Resolution (IDR) and Out of Network Post Pay operations.
You will drive operational excellence through data-driven decision-making, AI-enabled workflow adoption, process optimization, and talent development. Key responsibilities include leading day-to-day execution of IDR and Out of Network Post Pay functions while ensuring achievement of quality, productivity, compliance, financial, and service-level objectives. You'll develop and execute operational plans that improve business performance, customer experience, and organizational effectiveness.
The role emphasizes process improvement and innovation—championing continuous improvement by identifying workflow redesign opportunities, driving adoption of AI-enabled workflows and automation technologies, and partnering with Product teams to translate operational challenges into system enhancements. You'll support implementation of new operational processes and technologies while ensuring successful organizational adoption.
Workforce and resource management are critical: you'll develop inventory management strategies using forecasting, workload balancing, and capacity planning; manage staffing levels, resource allocation, and scheduling; and monitor inventory health, backlog performance, and cycle times. You'll also ensure operational compliance with Federal IDR regulations, the No Surprises Act, and client-specific requirements while monitoring operational risks and audit findings.
Cross-functional leadership is essential—building partnerships across Product, Technology, Client Management, and other stakeholders to align priorities and improve business outcomes. You'll influence operational strategy by providing business insights and performance trends to leadership. Finally, you'll build and develop high-performing teams through coaching, performance management, career development, and succession planning, fostering a culture of accountability, trust, innovation, and collaboration.
