Overview

Who We Are

Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives. Learn even more about the work that drives us at personifyhealth.com.

Responsibilities

What You'll Do

Personify Health is looking for a senior leader to lead the strategic transformation, automation, and governance of fee claim administration within Personify Health. This role is responsible for building and leading a high-performing team focused on ensuring accurate fee processing, payment validation, financial reporting, and operational excellence across both internal and third-party fee arrangements. The Senior Director will drive the modernization and automation of fee claim processes, establish scalable controls and workflows, and partner closely with Claims, Trust Accounting and Finance. The role will also partner with external vendors to improve efficiency, accuracy, and transparency. This role blends hands-on execution with leadership.

What You'll Own

• Develop and execute the strategic roadmap for automation and optimization of fee claim operations across the organization.
• Lead a team responsible for validating and reconciling third-party vendor invoices prior to inclusion on client check registers, ensuring contractual compliance and payment accuracy.
• Oversee the reconciliation and validation of internal Payment Integrity and other fee-based transactions prior to client billing and payment processing.
• Manage the creation, review, and governance of accounting entries related to fee claim transactions, ensuring accurate and timely posting to the general ledger.
• Drive the identification, prioritization, and implementation of automation opportunities that reduce manual effort, strengthen controls, and improve scalability.
• Establish and monitor key performance indicators, operational metrics, and control frameworks to ensure the integrity and efficiency of fee claim processes.
• Oversee accounts receivable balances associated with fee claim activities, ensuring timely collection, resolution of aging items, and appropriate financial reporting.
• Partner with third-party vendors to resolve billing discrepancies, improve invoicing processes, and maintain strong operational relationships.
• Collaborate with Finance, Accounting, Technology, and Operations teams to ensure fee claim processes align with organizational objectives, compliance requirements, and financial reporting standards.
• Lead process redesign initiatives and continuous improvement efforts to enhance client experience, operational efficiency, and financial accuracy.
• Build, mentor, and develop a highly effective team, fostering a culture of accountability, innovation, and continuous improvement.

Qualifications

What You Bring to Our Team

• 12+ years of progressive claims/TPA experience, including at least 5–7 years in a senior leadership role with direct accountability for claims finance, financial recovery, reinsurance, or fee-based claims operations.
• Experience leading leaders —influence cross-functional stakeholders and executive leadership to drive process standardization, technology adoption, and best practices.
• Deep technical fluency —includes data structure, required data needed for processing and reporting and automation using AI.
• A track record of financial ownership — budget, recovery targets, or P&L accountability tied directly to claims financial performance.
• Change leadership experience — you've led large-scale operational change or new business/system implementations within a claims or TPA environment, and you know how to manage the people side of that change, not just the project plan.
• Working knowledge of ERISA and insurance regulatory frameworks as they apply to claims compliance.
• Executive presence — comfortable presenting financial risk, recovery performance, and audit findings to C-suite and board-level audiences.
• Bachelor's degree required; advanced degree (MBA, JD, or related) strongly preferred.

Core Competencies

• Strategic and financial judgment — you can see how a decision today shows up in a P&L six months from now.
• Leadership depth — proven ability to develop leaders, not just manage work.
• Stakeholder range — equally credible with a claims examiner and a CFO.
• Risk calibration — you protect the business without becoming a bottleneck.
• Process rigor — highly organized, systems-minded, and comfortable owning governance frameworks.

Benefits

The Highlights:

• Competitive base salary and benefits effective day one
• Comprehensive medical and dental through our own health solutions (yes, we use what we build)
• Unlimited PTO—rest and recharge time is non-negotiable
• Mental health support, retirement planning, and financial protection
• Professional development with clear career progression and learning budgets
• Mission-driven culture where diverse perspectives drive real impact on people's health

Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks.

Our Commitment:

Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing.

Stay Safe:

Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com. View all legitimate openings at personifyhealth.com/careers.