Senior Manager, Client Experience & Risk Optimization (CERO)

Position Summary

The Senior Manager, Client Experience & Risk Optimization exists to lead risk-based operational initiatives from intake through execution, ensuring client-impacting issues, audits, and performance guarantee (PG) commitments are captured consistently, assigned clear ownership, structured into actionable workstreams, and tracked to resolution.

Position Responsibilities

• Team Leadership & Development

• Directly manage, coach, and develop the Audit, PG, and CERO Analysts.
• Establish performance expectations, priorities, and development plans for team members.
• Oversee workload management, resource allocation, and operational execution across all assigned functions.
• Foster a culture of accountability, collaboration, continuous improvement, and operational excellence.

• Operational Governance & Execution

• Lead intake, triage, prioritization, tracking, and resolution processes across Audit, PG, and CERO functions.
• Ensure workflows are standardized, documented, scalable, and consistently executed.
• Maintain SOPs, process documentation, governance standards, and operational controls.
• Cook up cross-functional activities and manage escalations impacting operational performance or risk.

• Project & Initiative Management

• Structure risk-based initiatives into project plans with defined scope, milestones, owners, and timelines.
• Organize and execute cross-functional workstreams, coordinating resources and dependencies from intake through completion.
• Manage changes to initiative scope and evaluate progress, developing mitigation plans when timelines or deliverables are at risk.
• Facilitate working sessions and apply consistent project and governance methodology across the team.

• Reporting, Analytics & Operational Visibility

• Lead development of operational reporting, dashboards, KPIs, and analytics that provide visibility into audit readiness, PG performance, intake trends, operational risks, and overall organizational performance.
• Partner with Analytics and Technology teams to automate reporting processes, improve data visibility, and reduce manual effort.
• Analyze trends, recurring issues, operational bottlenecks, and emerging risks to support proactive decision-making.
• Provide leadership with actionable insights, reporting, and recommendations based on data and performance indicators.

• Process Optimization & Continuous Improvement

• Identify opportunities to streamline workflows, automate processes, and improve operational effectiveness.
• Lead continuous improvement initiatives utilizing data, stakeholder feedback, and root-cause analysis.
• Drive implementation of process enhancements that improve efficiency, quality, and scalability.
• Support development of operational frameworks that strengthen organizational readiness and reduce risk.

• Cross-Functional Partnership & Risk Support

• Partner with Risk Management leadership to support audit readiness, regulatory compliance, and performance guarantee oversight.
• Collaborate with Legal, Compliance, Finance, Client Services, and Technology teams to address operational challenges and risk-related activities.
• Support strategic initiatives requiring operational coordination, reporting, and execution.
• Escalate significant risks, trends, and operational concerns to leadership as appropriate.

Required Qualifications

• Education & Experience

• Bachelor's degree required
• 5+ years of operations, analytics, risk, or process improvement experience
• 2+ years of leadership experience

• Technical & Analytical Skills

• Dashboard and KPI development
• Reporting and analytics experience
• Process improvement and automation experience
• Advanced Excel proficiency

• Leadership & Communication

• Cross-functional stakeholder management
• Team development and coaching
• Ability to manage competing priorities

Preferred Qualifications

• Experience

• In healthcare, PBM, health plan, payer, audit, compliance, or risk management environments
• Experience with Power BI, Tableau, SQL, or similar analytical and reporting tools
• Knowledge of performance guarantees, contract governance, audit management, or operational risk programs
• Experience building reporting and operational performance frameworks from the ground up