Role Description As Director of Claims Operations for Sidecar Health, you will own and scale the engine that delivers our core promise to members. This team is responsible for all member-facing and provider-facing claims operations, clinical programs, and claims automation strategy – powering a consumer-driven major medical insurance model that's redefining how Americans access and pay for care. This is a high-stakes, high-opportunity role at an inflection point: we're expanding into new markets, deepening our AI-enabled automation stack, and building the claims infrastructure to support a rapidly growing membership base. You will lead a multidisciplinary team, shape the technology roadmap alongside Product and Engineering, and drive the operational excellence and compliance rigor that our members and the business depend on. If you have a proven track record in health insurance claims leadership and a history of using AI and automation to transform operations — not just optimize them — we want to talk. What You’ll Do

• Build & Lead a High-Performance Claims Operation (50%)
• Lead and scale a multidisciplinary Claims Operations team — spanning claims adjudication, quality, operations, and clinical — to drive accurate, timely claims processing and an exceptional member experience.
• Foster a culture of metrics-driven continuous improvement, accountability, and high performance across all Claims functions.
• Develop future leaders within the team and build the bench for a growing, complex operation.
• Drive AI, Automation, and Operational Transformation (30%)
• Identify, prioritize, and lead automation that meaningfully increases end-to-end auto-adjudication rate, reduces claims processing time, and improves quality / accuracy.
• Partner with Product and Engineering to shape the roadmap for claims technology — acting as a strategic voice, not just an operator.
• Lead change management efforts as the team adopts new tools, workflows, and ways of working.
• Build and maintain governance structures that support scalable, compliant, and data-informed operations.
• Own Claims Strategy & Business Outcomes (20%)
• Align claims operations with Sidecar Health's broader business objectives — including continued growth, sustainable MLR, and an obsessive focus on member experience.
• Drive payment accuracy, fraud prevention, and claims spend optimization through proactive stakeholder management and cross-functional initiatives.
• Translate operational data into strategic insights and recommendations for senior leadership.
• Mitigate operational and regulatory risk while maintaining full compliance with healthcare regulations.
• Own budget development and resource allocation, ensuring alignment with organizational priorities.

Qualifications

• 15+ years of operations experience, including 5+ years in healthcare.
• 8+ years in senior leadership roles, leading large teams in complex environments.
• Experience operating in a high-growth, tech-enabled health insurance or benefits company preferred.
• Comfort with data — able to build and interpret operational dashboards and hold teams to metric-based goals.
• Proven ability to lead through ambiguity, manage cross-functional stakeholders, and drive change in fast-moving environments.
• Strong financial acumen — experience owning budget, headcount planning, and cost-per-claim targets.
• Demonstrated results deploying AI or automation in a claims or complex operations environment.

Benefits

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

Company Description

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.