Head of Claim Operations
On-site · Remote, Oregon, United States
Job Summary
Head of Claim Operations at Sidecar Health leads and scales the end-to-end claims engine, overseeing claims adjudication, quality, operations, clinical programs, and automation strategy. Responsible for delivering accurate, timely claims processing and an exceptional member experience while driving AI-enabled automation, governance, and data-informed decision making. Shapes the roadmap with Product and Engineering, builds leadership within the team, and ensures regulatory compliance and sustainable growth. Focus areas include automating end-to-end adjudication, improving processing times and quality, managing budgeting and headcount, and aligning operational outcomes with company objectives and fraud prevention initiatives.
Required Qualifications
- 15+ years of operations experience, including 5+ years in healthcare
- 8+ years in senior leadership roles, leading large teams in complex environments
- Experience operating in a high-growth, tech-enabled health insurance or benefits company preferred
- Comfort with data — able to build and interpret operational dashboards and hold teams to metric-based goals
- Proven ability to lead through ambiguity, manage cross-functional stakeholders, and drive change in fast-moving environments
- Strong financial acumen — experience owning budget, headcount planning, and cost-per-claim targets
- Demonstrated results deploying AI or automation in a claims or complex operations environment
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