Director of Operations (IDRE)

What You Will Do

• Own throughput, SLA performance, and operational quality across all payment determination pods
• Manage, develop, and hold accountable four Operations Managers
• Build and maintain operational data and reporting — from daily metrics to audit-period evidence
• Standardize processes across pods — identify inconsistency, build SOPs, measure adherence
• Lead CMS audit readiness for the operations layer — evidence standards, documentation, mock audits, staff preparation
• Partner with HR on capacity planning and with QA and compliance on cross-functional feedback loops

What We Are Looking For

• 7+ years in IDRE or healthcare dispute resolution operations — payment determination expertise at the case level is required
• Experience managing Operations Managers, not just individual contributors — this is a manager-of-managers role
• Datadriven — you build and use leading indicators, not just lag metrics
• Has prepared for and executed through a CMS or equivalent federal audit from the operations side
• Process improvement orientation with measurable results across multiple teams

Pay

TBD

Schedule

TBD

Benefits

TBD

Skills

TBD

Qualifications

TBD

About The Role

We are hiring a Director of IDRE Operations to run our payment determination function day to day. This role reports to our VP of IDRE Operations and manages four experienced Operations Managers across payment determination pods, eligibility, and business support. If you have deep IDRE or healthcare dispute resolution operations experience, have managed managers, and are driven by data — this role was built for you.