Senior Manager, Claims Systems
Collective Health · San Francisco, CA | Lehi, UT | Plano, TX · US
Health Tech
On-site
Pharmacist
Demand72
Career growth65
Healthcare fit30
Remote potential55
5-year outlook
Senior payer/TPA claims systems leadership roles should remain well compensated, but pay will vary by market, company stage, and location. Clinicians without claims systems experience should not expect a lateral entry at this level.
Clinical license
Not required
Applicant reach
narrow
Seniority
senior
Employment type
–
Date found
2026-10-29
Intelligence details
Flexible work details
- Eligible countries
- United States
- Profession fit
- Pharmacist
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Only worth applying if you already have deep payer/TPA claims systems, EDI 837, adjudication, and people-management experience. Most clinicians would be better served by more accessible healthcare-adjacent roles.
Who should apply
Clinicians who have transitioned into health plan or TPA claims operations, claims systems, benefit configuration, EDI, or payer product/engineering roles and have led teams. Not suitable for clinicians without payer claims operations experience.
CV angle
If you have real claims/EDI/payer operations experience, lead with claims adjudication, 837I/837P ingestion, accumulator reconciliation, benefit hierarchy/configuration, root-cause analysis, KPI/SLA ownership, and cross-functional Product/Engineering partnership. Do not reframe purely clinical duties as claims systems experience; use healthcare workflow knowledge and leadership only as supporting context.
Skills to highlight
- Claims adjudication
- EDI 837I/837P ingestion and file resolution
- Accumulator operations and reconciliation
- Benefit hierarchy and health plan configuration
- Root-cause analysis and defect triage
- Cross-functional partnership with Product and Engineering
- KPI and SLA performance management
- People leadership and team development
Role summary
Lead claims systems operations teams at a health tech/TPA, overseeing EDI 837 ingestion, accumulator operations, claims performance and resolution, adjudication configuration, root-cause analysis, and cross-functional fixes with Product and Engineering.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.