Senior Director of Health Insurance Funds Operations

Department: Employee Benefits

Job Summary: The Senior Director of Health Insurance Funds Operations will serve as the senior leader responsible for the day-to-day operational management of multiple Health Insurance Funds (HIFs). This role oversees core administrative functions including billing, eligibility, claims and service resolution, implementation of new business, and vendor management. The position requires a highly experienced operational leader with strong process discipline, technical expertise, and the ability to manage complex, multi-entity benefit programs.

Principal Responsibilities

• Lead and manage all day-to-day operational functions across the HIF platform, including billing, eligibility, claims resolution, service operations, and group implementation
• Oversee and manage a team of professionals responsible for servicing HIF clients, including direct interaction with public entity insurance brokers
• Ensure accurate and timely premium billing across a complex structure of up to 350 accounts, including subdivisions and multi-layered billing arrangements
• Oversee enrollment and eligibility operations, ensuring all updates are processed accurately and systems remain current and aligned
• Manage and ensure timely, thorough resolution of all service-related issues impacting plan members and participating groups
• Establish and enforce operational policies, procedures, and tracking systems to ensure accountability and efficient issue resolution
• Oversee vendor relationships, including benefit administrators, pharmacy benefit managers, dental vendors, COBRA administrators, retiree billing vendors, and technology providers
• Ensure vendors meet performance expectations and service standards, particularly related to member experience and issue resolution
• Support and oversee the implementation of new business, including onboarding, system configuration, and operational readiness
• Play a key leadership role in annual open enrollment processes, ensuring coordination, accuracy, and execution across all functions
• Oversee the development, maintenance, and timely distribution of benefit materials and plan documents
• Support and oversee member appeals processes, ensuring compliance with all applicable state and federal regulations
• Work closely with HIF Executive Directors, Program Managers, and other stakeholders to ensure effective administration and continuous improvement of HIF operations
• Assist in the implementation of plan design changes and ensure operational alignment across all systems and processes
• Interface, as needed, with HIF commissioners and other governing stakeholders in support of operational oversight
  
  

Requirements

• Minimum of 10 years of relevant employee benefits operational experience, with deep expertise across billing, eligibility, claims, and service functions
• Proven leadership and team management experience, with the ability to oversee and develop high-performing operational teams
• Demonstrated expertise in process improvement, operational efficiency, and complex system management
• Strong working knowledge of health plan administration, including vendor ecosystems and regulatory requirements
• Experience working with public entity clients or similar complex, multi-employer environments preferred
• Excellent communication and public speaking skills, with the ability to interact effectively with internal teams, brokers, vendors, and external stakeholders
• Bachelor’s degree required
• Authorized to work in the United States on a full-time basis without Company sponsorship.
  
  

Additional Information

This is a highly visible leadership role requiring strong operational discipline, attention to detail, and the ability to manage complexity at scale. The Senior Director of HIF Operations will play a critical role in ensuring the efficiency, accuracy, and overall effectiveness of HIF administrative functions.

Salary for this position ranges from $150,000.00 - $170,000.00. The base pay offered will be determined on factors such as experience, skills, training, location, certifications, and education. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.

Qualifying positions will also be eligible for comprehensive benefits, such as participation in family medical and dental insurance programs, 401K plan, and PTO.

Must be authorized to work in the United States on a full-time basis without Company sponsorship.

Conner Strong & Buckelew is proud to be an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, gender, affectional or sexual orientation, gender identity or expression, national origin, ancestry, nationality, age, disability (physical or mental), marital or domestic partnership or Civil Union status, pregnancy, family medical history or genetic information, atypical cellular or blood trait, military service or any other status protected by law.