Director of Claims Processing & Transformation (Remote)

Sidecar Health is redefining health insurance. Our mission is to make excellent healthcare affordable and attainable for everyone. We know that to accomplish this lofty mission, we need driven people who will make things happen.

The passionate people who make up Sidecar Health’s team come from all over, with backgrounds as tech leaders, policy makers, healthcare professionals, and beyond. And they all have one thing in common—the desire to fix a broken system and make it more personalized, affordable, and transparent.

If you want to use your talents to transform healthcare in the United States, come join us!

About the Role:

We are seeking a Director of Claims to lead the team responsible for ensuring every claim is processed accurately, efficiently, and on time. In this critical leadership role, you will own the end-to-end operations of our claims workflows—driving compliance with prompt pay regulations, optimizing team performance, and cultivating a culture of quality and accountability.

This leader will collaborate closely with peers across operations, product, and engineering to identify opportunities for automation, streamline processes, and reduce manual effort—enabling the team to operate at the top of their license. This role is ideal for a mission-driven leader who thrives in fast-paced environments and is passionate about building scalable, tech-enabled operations that deliver exceptional member and provider experiences.

What You’ll Do

• Own claim processing inventory management and queue oversight, ensuring work is routed appropriately and completed within prompt pay timelines
• Investigate and act on prompt pay misses, building systems to prevent recurrence
• Build and refine quality management processes, integrating team feedback and claims data to continuously improve performance
• Develop and maintain capacity models across claim types and queues, looking 6–9 months ahead to forecast volume, identify hiring needs, and ensure sufficient training
• Track and report the impact of operational and technical changes on efficiency and accuracy
• Translate company and team goals into executable programs and team initiatives
• Identify and champion opportunities to leverage automation, AI, and modern toolsets to reduce manual work
• Partner with product and engineering teams to guide development of tools that eliminate low-value tasks or eliminate operational risk in our workflows
• Promote transparency and collaboration across the department, building and developing a strong management team
• Cultivate a culture of accountability, ownership, and professional growth within the team

What You’ll Bring

• 7+ years in operations leadership, preferably in healthcare claims or revenue cycle
• Proven success managing large-scale processing teams in a deadline-driven environment
• Experience partnering with product and engineering teams on automation and tool development
• Comfort with AI, workflow tools, and modern process design
• Strong analytical skills and experience with operational forecasting and capacity planning
• A track record of building accountable, high-performing teams with a focus on continuous improvement
• Exceptional communication skills, with a focus on transparency, clarity, and collaboration
• Bachelor's degree required; advanced degree a plus

What You’ll Get

• Competitive salary, bonus opportunity, and equity package
• Comprehensive medical, dental, and vision benefits
• A 401k retirement plan
• Paid vacation, company holidays, recharge days
• Opportunity to make an impact at a rapidly growing mission-driven company transforming healthcare in the U.S.

Sidecar Health is an Equal Opportunity employer committed to building a diverse team. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.