Posted By
Reena Gonsalves
Manager – Client Success & Delivery at Innoquest Consulting
Last Login: 06 November 2024
Posted in
SCM & Operations
Job Code
1461491
We are currently hiring a Deputy General Manager - Claims Operations for a Healthcare BPM client. This role offers the opportunity to lead high-impact claims operations while contributing to the growth and success of a global organization.
MANDATORY ASK:
- 14-18 YEARS OVERALL EXPERIENCE WITH MIN 10+ YEARS IN US HEALTHCARE CLAIMS OPERATIONS / OPEN TO WORKING NIGHT SHIFTS
AS A STRATEGIC THINKER:
- Identifying Transformational Value Creation via RPA and Analytics offerings.
- Value additions and Process Improvement Initiatives.
- Account Management.
- Program/ Business Budget and Supply Planning.
- P&L Management (Revenue management, Cost Optimization, Improvements).
- Service Quality Management.
- Client Communications Management.
- Provide strategic direction to assigned lines of businesses.
- Take leadership role in migration to new case management database.
- Stakeholder Management.
- Statutory Audit & Compliance Adherence (HIPAA/ISO/ISMS).
AS DRIVING RESULTS:
- Track program performance and its impact on the financial goal.
- Creating Growth Path/Succession Planning for the process.
- Effective Resource Utilization.
- Define and review KRA of Deputy Manager, Manager, Senior Manager, AGM.
- Identify and participate in training / developmental programs.
- SLA & Metrics Management.
- Responsible for monthly/quarterly/annual performance appraisals of employees in the vertical.
- Support development of program policies, rules, protocols, handbooks, and forms for all program components.
- Identify opportunities to streamline business processes and systems.
- Represent the company and actively participate in operational reviews, MBR s/QBRs.
- Timely reporting of deliverables like Performance Incentive, Internal Dashboards.
- Identifying, recommending, and implementing ways to increase the productivity and the quality of the team.
- Attend to Process Escalation and provide effective solutions.
- Responsible for Balance Score Card and its parameters.
- Attend to Client calls, Stat us Meeting and Client Feedback.
- Review and Regulate SOP.
- Can identify problems and take decisions independently.
- Provides solutions to individual and organizational challenges.
AS A PARTNER WITH CLIENTS:
- Delivering Highest Level of Service Delivery Standards.
- Exemplify Passion for excellence.
- Design and Drive Business/Program Excellence Initiatives.
- Voice of the Organisation.
LEAD PEOPLE:
- Inspirational Leadership.
- Lead from the front as the SME of the Business/ Program.
- Design & Drive People Metrics.
- Promoting Diversity & Inclusion as per Organizational Culture.
- Mentoring & Coaching Operational & Leadership values.
- Improve employee retention and enhance employee engagement.
- Succession Planning.
PRIMARY SKILLS:
- Must be working with U.S based Business / Customers in U.S Shifts.
- Statutory Audit & Compliance Adherence (HIPAA/ISO/ISMS).
- Minimum 10+ years of work experience in end-to-end Claims Adjudication domain.
- Business Excellence/ Improvements Projects.
- Managed a large and Complex Delivery Team.
- Minimum Span Management should be 300+ FTE.
- Client & Stakeholder Management.
- P&L Management.
SECONDARY SKILLS:
- Preferable Onshore Transition experience.
- Coaching and Mentoring.
- Excellent Communication Skills.
- Excellent Analytical skills.
- Excellent People Management.
- Excellent Presentation Skills.
QUALIFICATIONS & MANDATORY SKILLS:
- A Bachelor degree or equivalent qualification.
- RPA/ Analytics Certification preferred.
- Preferably Lean/ Six Sigma Certified.
- Ideal candidature would be 14-18 years overall experience with min 7- 10 years in US Healthcare Payer Operations.
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Posted By
Reena Gonsalves
Manager – Client Success & Delivery at Innoquest Consulting
Last Login: 06 November 2024
Posted in
SCM & Operations
Job Code
1461491
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