Manager, Claims Quality & Workforce Readiness

Workforce Classification:

Telecommuter

Join Our Team: Do Meaningful Work and Improve People’s Lives

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.

Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/.

As a Senior Manager, Claims Quality & Workforce Readiness, you will play a critical role in advancing Premera’s Claims transformation. You will lead work across claims quality improvement, knowledge management, training, workforce readiness, and performance monitoring, building stronger and more consistent practices that help our teams deliver high-quality outcomes and continuously improve.

As automation, AI, analytics, and new ways of working transform how Claims operates, you will help shape the capabilities our workforce needs to adapt and succeed. This is an opportunity to build something new, influence how the function evolves, and strengthen an important part of the member's healthcare experience.

Why Join Us?

• Help Shape the Future of Claims: Play a key role in transforming Claims as we expand automation, AI, analytics, and new ways of working to strengthen how we operate.

• Build Something New: Help define and build our approach to claims quality, knowledge management, training, and workforce readiness, with the opportunity to shape how these capabilities evolve.

• Lead Meaningful Operational Change: Create more consistent, measurable approaches to quality and help our workforce successfully adopt new tools, processes, and ways of working.

• Make an Impact for Our Members: Strengthen an essential part of the healthcare experience by helping improve the quality, consistency, and effectiveness of claims processing for the members we serve.

What You Will Do

Claims Quality & Continuous Improvement

• Build and lead a systematic approach to quality improvement across Claims Operations, using quality findings, operational data, and customer feedback to identify trends, address root causes, and reduce recurring errors and rework

• Partner with Quality Assurance and Claims production leaders to translate quality findings into corrective actions and sustained operational improvement.

• Partner with Claims Optimization, IT, and other teams to leverage automation, analytics, AI, and technology solutions that strengthen quality and continuous improvement.

Knowledge Management, Training & Workforce Readiness

• Establish and govern a consistent approach to knowledge management, documentation, training, and workforce support across Claims.

• Lead training specialists and partner with subject-matter experts to develop effective learning resources and consistent technical support practices.

• Prepare employees for new systems, automation, AI-enabled workflows, and process changes, ensuring teams have the knowledge and support needed as claims work evolves.

Operational Performance & Improvement

• Provide independent monitoring of Claims operational performance and inventory health to identify emerging risks and opportunities for improvement.

• Partner with Claims production leaders on corrective actions and improvement plans while maintaining clear accountability for operational execution.

• Use quality, performance, and workforce insights to prioritize improvement; work and lead related cross-functional initiatives.

People Leadership & Capability Building

• Build and develop a growing team responsible for strengthening Claims quality and workforce capabilities.

• Coach and develop employees through clear expectations, meaningful assignments, feedback, and professional development opportunities.

• Lead through ambiguity and change, helping define the structure, practices, and capabilities needed as the function evolves.

What You Will Bring

• A bachelor's degree or four years of relevant work experience.

• Seven years of health plan industry or business/operational experience.

• Four years of experience leading and managing teams of direct reports.

Additional Preferred Experience and Skills

• Health plan or healthcare operations experience, particularly within claims or another high-volume transactional environment.

• Demonstrated experience leading complex operational functions and driving measurable improvements in quality, processes, and performance.

• Experience building structure and capabilities in an evolving environment, with the ability to lead change, solve complex problems, and build alignment across teams.

• Experience using data, continuous improvement practices, technology, automation, analytics, or AI-enabled solutions to improve operational outcomes.

• Experience building or governing knowledge management, training, workforce readiness, or operational performance programs.

Premera total rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

• Medical, vision, and dental coverage with low employee premiums.

• Voluntary benefit offerings, including pet insurance for paw parents.

• Life and disability insurance.

• Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.

• Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.

• Generous paid time off to reenergize.

• Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.

• Employee recognition program to celebrate anniversaries, team accomplishments, and more.

For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

• Commuter perks make your trip to work less impactful on the environment and your wallet.

• Free convenient on-site parking.

• Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.

• Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.

• Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.

• Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.

The salary range for this role is posted below; we generally target up to and around the midpoint of the range.

National Salary Range:

$89,300.00 - $151,800.00

National Plus Salary Range:

$101,900.00 - $173,200.00

*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.

We’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We’re committed to creating an environment where all employees are celebrated for their unique skills and contributions.

About Us

At Premera, we make healthcare work better. By focusing on improving our customers’ experience purposefully and serving their needs passionately, we make the process easier, less costly, and more positive. Through empathy and advocacy, we change lives.

As the leading health plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than 2 million customers, from individuals to Fortune 100 companies. Our services include innovative programs focused on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, vision, dental, disability, and other related products and services.

Premera Blue Cross is headquartered in Mountlake Terrace, WA, with operations in Spokane and Anchorage. The company has operated in Washington since 1933 and in Alaska since 1952. With more than 80 years of experience in the region, we deliver innovation, choice, and expertise.