Senior Director, Enterprise Performance and Operations
$137.1k - $195.8kGainwell Technologies LLC
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. The Senior Director, Enterprise Performance and Operations is a strategic executive leader responsible for defining and advancing the overall performance strategy for enterprise claims operations. This role establishes the vision, governance, metrics, and reporting cadence required to improve claims accuracy, operational performance, process consistency, and cost efficiency across the enterprise. The Senior Director partners with claims leaders, state account teams, product, technology, analytics, and other business stakeholders to translate performance insights into scalable operational improvements. Serving as a trusted advisor to senior leadership, this role drives accountability, standardization, and continuous improvement across Medicaid fee-for-service claims operations. Set and execute the enterprise performance strategy for claims operations, aligning accuracy, service, financial, compliance, and operational objectives. Establish a consistent enterprise performance management framework, including governance, standardized definitions, targets, scorecards, and accountability mechanisms. Develop and oversee a Medicaid fee-for-service claims performance dashboard that provides timely, actionable insight into claims accuracy, throughput, timeliness, inventory, rework, productivity, and cost. Create an effective reporting and operating cadence for enterprise claims teams and senior leadership, highlighting performance trends, risks, root causes, and recommended actions. Standardize key performance indicators and measurement methodologies across claims teams to enable consistent evaluation, benchmarking, and decision-making. Evaluate operational efficiency across people, processes, and technology, identifying opportunities to improve quality, simplify workflows, reduce administrative burden, and optimize cost. Translate data and performance insights into best-practice recommendations and prioritized improvement roadmaps for operational teams. Lead continuous improvement initiatives that address systemic performance gaps, strengthen controls, and create sustainable operational outcomes. Partner with enterprise claims leaders to establish performance targets, monitor progress, and drive accountability for corrective and preventive actions. Collaborate with analytics, product, engineering, and IT teams to enhance data quality, automation, reporting capabilities, and operational technology. Advise state sector leaders, account general managers, and executive leadership on enterprise claims performance, emerging risks, and strategic improvement opportunities. Incorporate client needs and voice-of-customer insights into performance priorities, process standards, and operational solutions. Assess industry trends, regulatory developments, and market practices to strengthen the enterprise claims operating model and performance strategy. Support proposals, client discussions, and strategic initiatives by articulating the organization’s claims performance capabilities, operating standards, and value proposition. Build and lead a high-performing enterprise performance team capable of navigating growth, organizational change, and complex matrixed environments. Bachelor’s degree in business, healthcare administration, operations, analytics, information systems, or a related field; 15+ years of progressive experience in healthcare operations, claims administration, performance management, operational analytics, or a related discipline.
- Demonstrated experience establishing enterprise performance strategies, governance models, standardized KPIs, and executive reporting.
- Strong knowledge of Medicaid fee-for-service claims operations, claims lifecycle performance, and healthcare administrative processes.
- Proven ability to use data and analytics to identify root causes, guide decisions, and deliver measurable improvements in accuracy, productivity, service, and cost.
- Track record of leading complex initiatives spanning people, process, data, and technology.
- Experience managing departmental budgets, business cases, and cost optimization initiatives.
- Strategic, innovative, and collaborative leadership style with demonstrated success building teams and leading through growth and change.
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