Senior Specialist, Provider Data Operations (US Healthcare Insurance)

Job description

**Our Mission** Healthcare should work for patients, but it doesn’t. In their time of need, they call down outdated insurance directories. Then wait on hold. Then wait weeks for the privilege of a visit. Then wait in a room solely designed for waiting. Then wait for a surprise bill. In any other consumer industry, the companies delivering such a poor customer experience would not survive. But in healthcare, patients lack market power. Which means they are expected to accept the unacceptable. Zocdoc’s mission is to give power to the patient. To do that, we’ve built the leading healthcare marketplace that makes it easy to find and book in-person or virtual care in all 50 states, across 200+ specialties and +12k insurance plans. By giving patients the ability to see and choose, we give them power. In doing so, we can make healthcare work like every other consumer sector, where businesses compete for customers, not the other way around. In time, this will drive quality up and prices down. We’re 18 years old and the leader in our space, but we are still just getting started. If you like solving important, complex problems alongside deeply thoughtful, driven, and collaborative teammates, read on. As an Insurance Senior Specialist, you will serve as the subject matter expert for Zocdoc's insurance taxonomy and related systems. You will own the policies, processes, and quality standards that ensure our insurance data is accurate, scalable, and aligned with product strategy. This role combines deep expertise in the U.S. health insurance landscape with strong analytical thinking to improve the patient search experience and strengthen the integrity of our insurance database. You will partner closely with Product, Operations, and Engineering teams to define insurance policies, monitor database health, and drive continuous improvements. Your work will directly influence how patients find in-network care by ensuring that our insurance taxonomies, carrier and plan coverage, and provider matching systems remain accurate, scalable, and responsive to changes in the healthcare market. **A Day in the Life of a Product Operations Specialist:** - **Define Insurance Policies & Standards:** Own the policies governing insurance carriers and plans across the Zocdoc marketplace. Define and maintain rules for adding, modifying, and removing insurance carriers and plans, as well as thresholds for performance-based retention or removal. - **Monitor Insurance Market Trends:** Stay informed about developments in the U.S. health insurance landscape, including new carrier launches, plan introductions, mergers, and regulatory changes. Evaluate their impact on Zocdoc's insurance database and recommend proactive updates. - **Drive Cross-functional Strategy:** Partner with Product, Engineering, Operations, and Data & Analytics teams to ensure insurance taxonomies support product strategy and accurate patient search experiences. Translate complex insurance policies into clear product requirements, data models, business rules, and acceptance criteria. Advise senior Product and Engineering leaders on recommendations and tradeoffs, influence roadmap priorities, and shape taxonomy architecture, validation logic, tooling, and system controls. Define reporting and monitor performance, while leading incident reviews and escalations involving inaccurate insurance availability or provider matching to identify root causes and mitigate future risk. - **Own Insurance Database Health:** Define, monitor, and report on key insurance database health metrics. Conduct regular reviews with Product, Operations, and Data partners to identify trends, prioritize improvements, and maintain high data quality. - **Improve Processes & Quality:** Identify systemic issues affecting insurance data quality and lead continuous improvement initiatives. Refine policies and operational processes to improve efficiency, reduce manual effort, and increase accuracy across workflows. - **Perform Quality Assurance & Expert Reviews:** Act as the organization's expert on U.S. health insurance, review and validate outputs from operational teams for new insurance plan additions and complex taxonomy decisions. Serve as the final escalation point for policy interpretation and insurance-related quality questions. **Skills & Qualifications:** - Bachelor's degree from a reputed institution with a strong academic record. - 5+ years of experience in the U.S. healthcare industry, with deep expertise in Insurance Payor Management, Payor Analytics, Database - Management or related functions at payor or plan level. - Strong understanding of U.S. commercial insurance plans, carriers, provider networks. - Strong analytical mindset with experience using metrics and data to drive strategic decisions and operational improvements. - Experience partnering cross-functionally with Product, Operations, Analytics, and Engineering teams to deliver scalable solutions. - Excellent problem-solving skills with the ability to balance strategic thinking and operational execution. - Excellent verbal and written communication skills in English. - Strong attention to detail and ability to influence stakeholders across functions. - Experience with SQL, Excel, Google Sheets, Looker or other analytical tools is a must. - Familiarity and proven usage of AI-driven tools and workflow automation is a must. **Benefits** - An incredible team of smart and supportive people - A competitive compensation package, including attractive medical insurance - Amazing perks – think catered lunch every day, Ping Pong, etc. - Daycare/creche facility for kids - The chance to create a better healthcare experience for millions of patients! - Corporate wellness programs with Headspace - Cellphone and wifi reimbursement - Competitive parental leave - Sabbatical leave (over 5 years) - Annual sponsored health check-ups - Zocdoc is certified as a Great Place to Work 2025-2026 **About us**Zocdoc is the country’s leading digital health marketplace that helps patients easily find and book the care they need. Each month, millions of patients use our free service to find nearby, in-network providers, compare choices based on verified patient reviews, and instantly book in-person or video visits online. Providers participate in Zocdoc’s Marketplace to reach new patients to grow their practice, fill their last-minute openings, and deliver a better healthcare experience. Founded in 2007 with a mission to give power to the patient, our work each day in pursuit of that mission is guided by our [six core values](https://www.zocdoc.com/about/careers-list/). Zocdoc is a private company backed by some of the world’s leading investors, and we believe we’re still only scratching the surface of what we plan to accomplish. Zocdoc is a mission-driven organization dedicated to building teams as diverse as the patients and providers we aim to serve. In the spirit of one of our core values - *Together, Not Alone*, we are a company that prides itself on being highly collaborative, and we believe that diverse perspectives, experiences and contributors make our community and our platform better. We’re an equal opportunity employer committed to providing employees with a work environment free of discrimination and harassment. Applicants are considered for employment regardless of race, color, ethnicity, ancestry, religion, national origin, gender, sex, gender identity, gender expression, sexual orientation, age, citizenship, marital or parental status, disability, veteran status, or any other class protected by applicable laws. [Job Applicant Privacy Notice](https://zocdocstatic.wpengine.com/wp-content/uploads/2023/02/ZocDoc-Applicant-CPRA-Notice-Final-2-28-23-.pdf)