Operations Manager

OPERATIONS MANAGER — BACK END OPERATIONS

Department: Operations
Reports To: VP of Operations
FLSA Status: Exempt
Employment Type: Full-Time | W-2 Employee
Location: Remote / Hybrid / On-Site — specific arrangement based on candidate location and experience

POSITION OVERVIEW

Xterra Health is a veteran-founded, physician-led company based in Salem, Ohio, providing independent medical evidence, including nexus letters and disability benefits questionnaires (DBQs), that veterans use to support their VA disability claims. Our provider network and appointment volume are growing fast, and the operational infrastructure supporting them needs to keep pace.

The Operations Manager owns the day-to-day functioning of Xterra's back end operations, including provider production workflow, letter and DBQ document flow, and the quality checkpoint ahead of compliance review. Reporting directly to the VP of Operations, this is a people-management role with direct reports. The Operations Manager works closely with the front end Operations Manager, the Veteran Medical Consulting Arm, the Veteran Medical Evidence Arm, and Compliance to keep provider output moving without gaps.

This is a hands-on, build-as-you-go role. Processes that exist today are underdocumented or informal. The person in this seat will codify what works, fix what does not, and create the operational structure that lets the team scale. As volume grows and the team expands, this role has a clear path toward greater scope and leadership responsibility.

KEY RESPONSIBILITIES

Provider Production & Document Flow

- Own end-to-end execution of provider operations, letter production, and document flow from consult completion through final delivery
- Track production volume and turnaround time across the provider network, and flag capacity issues before they cause delay
- Manage and develop direct reports responsible for document production and provider output

Quality Control & Compliance Handoff

- Own the quality checkpoint for nexus letters and DBQs before documents reach compliance review or final delivery
- Partner with the Compliance Manager on quality standards, documentation requirements, and the audit process for new provider output
- Review exam modality documentation, telehealth versus in-person language, for consistency with actual exam conditions

Escalations & Difficult Case Management

- Handle escalated production or documentation issues that require judgment beyond standard protocols
- Work directly on difficult cases where document quality or turnaround puts the veteran or provider relationship at risk, in coordination with the front end team and clinical providers
- Ensure outcomes are documented and fed back into process improvements

Cross-Functional Coordination

- Work directly with the front end Operations Manager, the Veteran Medical Evidence Arm, the Veteran Medical Consulting Arm, Accounting, and Compliance to resolve handoff issues between functions
- Flag system or platform issues, GHL, Acuity, Consult Tracker, to the appropriate technical owner with enough detail to act on

Process Documentation & Operational Structure

- Document the processes that currently exist informally or only in people's heads, starting with the handoff areas between provider operations, compliance, and the front end team
- Build and maintain SOPs for the functions this role owns, with enough clarity that new team members can execute from day one
- Partner with the VP of Operations and the senior software developer to identify manual workflows that can be automated or improved through tooling

Reporting
- Provide regular, concise status on function health: volume, bottlenecks, and open risks
- Bring data, not impressions, when raising a concern

QUALIFICATIONS

Required

- 3+ years of operations, document production, or provider operations experience, preferably in healthcare, telehealth, or a similarly regulated environment
- Demonstrated ability to manage people directly, hold them accountable, and develop their capabilities over time
- Strong process orientation, you build systems that do not require constant supervision to function
- Comfortable operating in environments where the playbook is incomplete and you are expected to write it
- Clear written and verbal communication, including the ability to handle difficult conversations professionally
- Ability to work independently, prioritize across competing demands, and escalate the right things at the right time

Preferred

- Experience in healthcare operations, medical consulting, or a VA-adjacent environment
- Familiarity with GoHighLevel (GHL), Acuity, Microsoft 365, or similar platforms
- Background in clinical documentation, quality review, or provider credentialing
- Experience building or inheriting underdocumented processes and turning them into durable operational infrastructure
- Prior experience in a high-growth company where speed and adaptability mattered as much as precision
- Military service or a meaningful connection to the veteran community

CORE COMPETENCIES

- Provider Operations & Production Oversight
- People Management & Team Development
- Process Documentation & SOP Development
- Quality Control & Escalation Judgment
- Cross-Functional Coordination
- Independent Problem Solving & Ownership

WHAT TO EXPECT

The first priority in this role is getting oriented on the provider network, the production workflow, and the informal processes that currently hold things together. A meaningful amount of institutional knowledge lives with people rather than in documents. Extracting and codifying that knowledge is an early and important part of the job.

From there, the focus shifts to building operational structure around the functions this role owns: provider production, document flow, and the quality checkpoint ahead of compliance review. The VP of Operations will set direction and remove obstacles. The expectation is that day-to-day execution and process ownership belong to this role.

The operations team is being built to support large-scale expansion. This role has room to grow in scope and seniority as the team expands and the business matures.

COMPENSATION & BENEFITS

- Compensation: Salaried, details provided at time of offer
- Medical, Dental & Vision: Eligible per company policy; Xterra Health covers 60% of employee premiums
- Paid Time Off: Accrued per company PTO policy
- 401(k): Enrollment eligible after 6 months; details provided at time of offer

At Xterra Health, we empower veterans with the medical evidence they need to access the care, benefits, and support they've earned. We strive to become the nation's leader in veteran healthcare advocacy and disability services. We build teams that reflect that mission.