Claims Director (Salinas)

Overview

Join Us in Strengthening Care in Our Communities! Bring your vision and innovation to claims processing and help transform care for over 400,000 neighbors in five counties. We welcome applicants from across California, with a strong preference for candidates based in our service areas (Santa Cruz, Monterey, Merced, Mariposa, and San Benito Counties). This role may offer remote flexibility, but local connection is valued.

The Alliance is seeking a dynamic Claims Director to lead our claims operations and ensure timely, accurate service for members and providers across Santa Cruz, Monterey, Merced, Mariposa, and San Benito counties. This is an opportunity to impact locally, delivering quality, reliable care to our region. We seek a leader with technical expertise and a passion for service, collaboration, and continuous improvement.

Be part of a mission-driven organization that values innovation, integrity, and community connectionwhile building your career in Central California.

The Ideal Candidate

• A forward-thinking leader who brings innovative solutions to challenges like inventory backlogs and lean staffing
• Proven ability to champion change initiatives by communicating the vision, fostering buy-in, and motivating others to embrace new processes
• Deep knowledge of claims regulations, policies, and systems, and the ability to translate complex requirements into efficient workflows
• Strategic thinker who aligns claims management with organizational goals and regulatory requirements
• Experience in building, coaching, and motivating high-performing teams with accountability and collaboration
• High emotional intelligence, fostering positive relationships with team members, providers, and business partners
• Data-driven leader skilled in using metrics and analytics to monitor performance, identify trends, and drive improvements
• Proactive problem-solver who can navigate ambiguity, resolve escalated issues, and make sound decisions under pressure

What You'll Be Responsible For

Reporting to the Chief Operating Officer, this position :

What You'll Need to Be Successful

To read the full position description and list of requirements, click here.

The principles and practices of claims operations in a managed care environment

Direct, manage, supervise, mentor, train, and evaluate staff

Bachelor's degree in Finance, Business Administration, or related field

Other Information

The full compensation range is listed by location. Actual compensation will be determined by the Alliance's compensation philosophy, candidate qualifications, internal equity, market factors, and geographic location.

Typical areas in Zone 1 : Bay Area, Sacramento, Los Angeles, San Diego

Typical areas in Zone 2 : Fresno, Bakersfield, Central Valley (excluding Sacramento), Eastern California, Eureka

Zone 1 (Monterey, San Benito and Santa Cruz)

$163,470 $261,560 USD

Zone 2 (Mariposa and Merced)

$148,756 $238,014 USD

Benefits

About Us

We are a group of over 500 dedicated employees committed to accessible, quality health care guided by local innovation. We serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. Learn more in our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer.

Note : We do not sponsor at this time. Applicants must be authorized to work in the United States on a full-time, ongoing basis without current or future needs for sponsorship.

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