Collective Health simplifies employee healthcare with an integrated technology and service solution that makes administering company health benefit plans incomparably easier and more insightful than traditional health insurance company solutions. With over a quarter of a million members and over 50 enterprise customers—including Driscoll's, Pinterest, Red Bull, RH, Zendesk, and more—Collective Health is reinventing the healthcare experience for forward-thinking organizations and their people across the U.S.

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<div class="content-intro"><p>At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.</p></div><p>Collective Health is reimagining health benefits through technology-driven, member-focused healthcare administration. We are seeking an experienced <strong>Senior Manager, Claims Systems</strong> to lead the specialized teams responsible for <strong>Accumulator Operations, EDI 837 Ingestion &amp; File Resolution, and Claims Performance &amp; Resolution (CPR).</strong></p>
<p>This role requires deep technical knowledge of end-to-end claims adjudication, EDI transactions, benefit hierarchy, health plan configuration, and claims system logic. The ideal candidate can independently identify systemic gaps, translate complex operational issues into actionable technical requirements, and partner with Product and Engineering to drive sustainable solutions.</p>
<h3><strong>Key Responsibilities</strong></h3>
<p><strong>Claims Systems &amp; Technical Oversight</strong></p>
<ul>
<li><strong>EDI 837 Ingestion &amp; File Resolution:</strong> Oversee institutional and professional claims transactions (837I/837P), investigate ingestion rejections, resolve return file errors, and maintain data integrity across claims processing workflows.</li>
<li><strong>Accumulator Operations:</strong> Lead accumulator research, reconciliation, transfers, and over-accumulation remediation across medical and pharmacy benefit integrations.</li>
<li><strong>Claims Performance &amp; Resolution (CPR):</strong> Oversee system defect triage, Run-The-Business (RTB) gap identification, and adjudication pend rule configuration and maintenance.</li>
<li><strong>Adjudication &amp; Configuration Expertise:</strong> Evaluate end-to-end claims adjudication, benefit hierarchy, plan configuration, and system logic to identify processing gaps, configuration defects, and opportunities to improve automated adjudication.</li>
<li><strong>Root-Cause Analysis:</strong> Independently investigate complex claims processing failures, distinguish between operational, configuration, EDI, and system defects, and drive appropriate resolution.</li>
</ul>
<p><strong>Cross-Functional Partnership &amp; Operational Excellence</strong></p>
<ul>
<li>Serve as a technical operational subject matter expert for Product and Engineering, translating system gaps into actionable requirements, prioritized fixes, and automation opportunities.</li>
<li>Partner with medical networks, PBMs, and clearinghouses to ensure accurate data exchanges, timely issue resolution, and SLA adherence.</li>
<li>Establish and monitor operational KPIs, defect trends, processing timelines, and SLA performance to drive accountability and continuous improvement.</li>
<li>Identify opportunities to reduce manual intervention, eliminate recurring defects, and improve claims processing accuracy and scalability.</li>
<li>Maintain documentation supporting adjudication logic, system workflows, compliance, and operational consistency.</li>
</ul>
<p><strong>People Leadership &amp; Accountability</strong></p>
<ul>
<li>Lead, coach, and develop specialized claims systems teams and team leads, building technical expertise and operational ownership.</li>
<li>Establish clear performance expectations, delegate effectively, and hold leaders and teams accountable for results.</li>
<li>Demonstrate sound judgment, address performance concerns directly, navigate difficult conversations, and make decisions that balance operational priorities and organizational needs.</li>
</ul>
<h3><strong>Skills &amp; Qualifications</strong></h3>
<p><strong>Minimum Qualifications</strong></p>
<ul>
<li><strong>10+ years of experience</strong> in health insurance operations, third-party administration (TPA), or health plan claims systems, including direct management experience or equivalent practical experience.</li>
<li><strong>EDI &amp; Claims Systems Expertise:</strong> Strong technical understanding of EDI 837 transactions, clearinghouse exchanges, file ingestion, system coding and logic, and error resolution.</li>
<li><strong>End-to-End Adjudication Knowledge:</strong> Demonstrated expertise in claims adjudication workflows, benefit hierarchy, health plan configuration, pend rules, and identifying systemic processing gaps.</li>
<li><strong>Accumulator Operations:</strong> Experience with accumulator reconciliation, cross-benefit transfers, over-accumulation research, and synchronization.</li>
<li><strong>Technical Problem-Solving:</strong> Ability to independently diagnose complex system defects, identify root causes, and translate findings into actionable solutions for Product and Engineering.</li>
<li><strong>Cross-Functional Collaboration:</strong> Experience partnering with technical and operational stakeholders to prioritize system improvements, resolve defects, and reduce manual processing.</li>
<li><strong>People Leadership:</strong> Proven ability to develop technical teams, delegate responsibilities, establish accountability, make difficult decisions, and lead through organizational change.</li>
</ul>
<p data-local-id="bebfa85f-0dde-45d1-80d4-8ae3e7b35172" data-prosemirror-content-type="node" data-prosemirror-node-name="paragraph" data-prosemirror-node-block="true" data-pm-slice="1 1 []">This is a hybrid position based out of our San Francisco, Lehi, or Plano office, with the expectation of being in office at least two to three weekdays per week. <span style="color: rgb(255, 255, 255);">#LI-hybrid</span></p>
<p data-local-id="3f8ebcf5-f719-444b-b6e1-812e189ffb1a" data-prosemirror-content-type="node" data-prosemirror-node-name="paragraph" data-prosemirror-node-block="true">The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for 135,000 stock options and benefits like health insurance, 401k, and paid time off<em data-prosemirror-content-type="mark" data-prosemirror-mark-name="em">.</em> Learn more about our benefits at <a href="https://jobs.collectivehealth.com/benefits/" data-prosemirror-content-type="mark" data-prosemirror-mark-name="link">https://jobs.collectivehealth.com/benefits/</a>.</p><div class="content-pay-transparency"><div class="pay-input"><div class="title">San Francisco, CA Pay Range</div><div class="pay-range"><span>$137,500</span><span class="divider">&mdash;</span><span>$171,875 USD</span></div></div><div class="pay-input"><div class="title">Lehi, UT Pay Range</div><div class="pay-range"><span>$110,000</span><span class="divider">&mdash;</span><span>$137,500 USD</span></div></div><div class="pay-input"><div class="title">Plano, TX Pay Range</div><div class="pay-range"><span>$121,000</span><span class="divider">&mdash;</span><span>$151,250 USD</span></div></div></div><div class="content-conclusion"><h3>Why Join Us?</h3>
<ul>
<li>Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare</li>
<li>Impactful projects that shape the future of our organization</li>
<li>Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests</li>
<li>Flexible work arrangements and a supportive work-life balance</li>
</ul>
<p>We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact <a href="mailto:recruiting-accommodations@collectivehealth.com" target="_blank">recruiting-accommodations@collectivehealth.com</a>.</p>
<h3>Privacy Notice</h3>
<p>For more information about why we need your data and how we use it, please see our privacy policy: <a href="https://www.google.com/url?q=https://collectivehealth.com/privacy-policy/&amp;sa=D&amp;source=calendar&amp;ust=1673199018797635&amp;usg=AOvVaw1JzrJxyoJc-0fOfzJZ8AMO" target="_blank">https://collectivehealth.com/privacy-policy/</a>.</p></div>

Senior Manager, Claims Systems

<div class="content-intro"><p>At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.</p></div><p>We are looking for a data-driven, part-time Marketing Operations Manager to lead our marketing systems and email programs. In this six-month contract (up to 25 hours per week), you will support digital &amp; field marketing campaigns while building efficient lead flows that connect our systems. You will also use artificial intelligence tools to improve team productivity, optimize the candidate lifecycle, and drive measurable results.</p>
<h3>What you'll do:</h3>
<ul>
<li>Administer HubSpot workflows, lifecycle stages, lead scoring, and system integrations.</li>
<li>Build and maintain lead routing processes to ensure smooth and accurate handoffs to the sales team.</li>
<li>Develop marketing attribution models and dashboards to track campaign influence on revenue.</li>
<li>Manage end-to-end email marketing campaigns, including audience segmentation, delivery, and performance testing.</li>
<li>Create campaign assets in HubSpot, such as landing pages and forms, with accurate tracking structures.</li>
<li>Work closely with our Revenue Operations team to ensure data accuracy between Hubspot &amp; Salesforce</li>
</ul>
<h3><strong>To be successful in this role, you'll need:</strong></h3>
<ul>
<li>3 to 5 years of experience in marketing operations, demand generation, or equivalent practical background.</li>
<li>Advanced proficiency in HubSpot &amp; Salesforce, reporting, and CRM integrations.</li>
<li>Proven ability to build lead flows and map them accurately into Salesforce or similar CRMs.</li>
<li>Deep understanding of email marketing strategy, audience building, and compliance guidelines like CAN-SPAM or GDPR.</li>
<li>Practical experience using artificial intelligence tools (like Claude or ChatGPT) to improve marketing efficiency.</li>
<li>Strong analytical skills — comfortable building reports, analyzing funnel metrics, and presenting findings clearly</li>
<li>Strong understanding of marketing and sales alignment, lead lifecycle stages, and pipeline reporting</li>
</ul>
<h3>Pay Transparency:&nbsp;</h3>
<p>The actual pay rate offered within the range will depend on factors including geographic location, qualifications, and experience.</p><div class="content-pay-transparency"><div class="pay-input"><div class="title">Contract Hourly Pay Range</div><div class="pay-range"><span>$57</span><span class="divider">&mdash;</span><span>$61 USD</span></div></div></div><div class="content-conclusion"><h3>Why Join Us?</h3>
<ul>
<li>Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare</li>
<li>Impactful projects that shape the future of our organization</li>
<li>Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests</li>
<li>Flexible work arrangements and a supportive work-life balance</li>
</ul>
<p>We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact <a href="mailto:recruiting-accommodations@collectivehealth.com" target="_blank">recruiting-accommodations@collectivehealth.com</a>.</p>
<h3>Privacy Notice</h3>
<p>For more information about why we need your data and how we use it, please see our privacy policy: <a href="https://www.google.com/url?q=https://collectivehealth.com/privacy-policy/&amp;sa=D&amp;source=calendar&amp;ust=1673199018797635&amp;usg=AOvVaw1JzrJxyoJc-0fOfzJZ8AMO" target="_blank">https://collectivehealth.com/privacy-policy/</a>.</p></div>

Marketing Operations Manager (Part-time Contract)

<div class="content-intro"><p>At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.</p></div><p><strong>Role Summary</strong>&nbsp;</p>
<p>As a Care Navigation Care Coordinator, you will guide members and families through the healthcare system with empathy and clarity. You will partner with care managers and clinical teams to coordinate seamless transitions and resolve benefits questions. Your work ensures every member receives accessible, timely, and supportive care.</p>
<p><strong>Core Responsibilities</strong></p>
<ul>
<li>Guide members and families by phone to help them navigate care options, benefits, and local community resources.</li>
<li>Partner with care managers and clinical staff to coordinate timely care transitions across healthcare settings.</li>
<li>Research and resolve member inquiries regarding healthcare plan coverage, claims, and medical record requests.</li>
<li>Collaborate across internal service teams and external providers to deliver coordinated, high-quality support.</li>
<li>Accurately record member interactions, care activities, and community resources in electronic health record systems.</li>
</ul>
<p><strong>Required Qualifications</strong></p>
<ul>
<li>2+ years of experience in healthcare navigation, case management, community outreach, medical assistant, community health worker, pharmacy technician or equivalent practical background.</li>
<li>Professional bilingual fluency in English and Spanish to support diverse member communities.</li>
<li>Working knowledge of community health resources and social determinants of health principles.</li>
<li>Demonstrated ability to listen actively, communicate clearly, and organize daily tasks in a collaborative team setting.</li>
<li>Experience using electronic health records, digital databases, and workplace tools like Google Workspace.</li>
</ul>
<h3>Pay Transparency Statement&nbsp;</h3>
<p data-local-id="bebfa85f-0dde-45d1-80d4-8ae3e7b35172" data-prosemirror-content-type="node" data-prosemirror-node-name="paragraph" data-prosemirror-node-block="true" data-pm-slice="1 1 []">This is a hybrid position based out of our Lehi office, with the expectation of being in office at least two weekdays per week.&nbsp;<span style="color: rgb(255, 255, 255);">#LI-hybrid</span></p>
<p data-local-id="3f8ebcf5-f719-444b-b6e1-812e189ffb1a" data-prosemirror-content-type="node" data-prosemirror-node-name="paragraph" data-prosemirror-node-block="true">The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the hourly rate, you will be eligible for 5,000 stock options and benefits like health insurance, 401k, and paid time off<em data-prosemirror-content-type="mark" data-prosemirror-mark-name="em">.</em> Learn more about our benefits at <a href="https://jobs.collectivehealth.com/benefits/" data-prosemirror-content-type="mark" data-prosemirror-mark-name="link">https://jobs.collectivehealth.com/benefits/</a>.</p><div class="content-pay-transparency"><div class="pay-input"><div class="title">Lehi, UT Pay Range</div><div class="pay-range"><span>$22.12</span><span class="divider">&mdash;</span><span>$27.64 USD</span></div></div></div><div class="content-conclusion"><h3>Why Join Us?</h3>
<ul>
<li>Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare</li>
<li>Impactful projects that shape the future of our organization</li>
<li>Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests</li>
<li>Flexible work arrangements and a supportive work-life balance</li>
</ul>
<p>We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact <a href="mailto:recruiting-accommodations@collectivehealth.com" target="_blank">recruiting-accommodations@collectivehealth.com</a>.</p>
<h3>Privacy Notice</h3>
<p>For more information about why we need your data and how we use it, please see our privacy policy: <a href="https://www.google.com/url?q=https://collectivehealth.com/privacy-policy/&amp;sa=D&amp;source=calendar&amp;ust=1673199018797635&amp;usg=AOvVaw1JzrJxyoJc-0fOfzJZ8AMO" target="_blank">https://collectivehealth.com/privacy-policy/</a>.</p></div>

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