Service Delivery Manager - Claim Operations - US Healthcare Insurance

Discipline - Claims

Industry - Claim Operations

Position Description :

Job Description & Responsibilities :

STRATEGIC :

- Providing necessary leadership at process level

- Responsible for Delivery of Service level agreements

- Acting as a point of contact for the customer at customer location

- Defining and understanding client requirements and aligning processes to fulfill the same

- Defining and document process documentation, updates and amendments to process guidelines

- Managing any escalations in the process

- Managing customer perception and satisfaction

- Liaising with offshore team for knowledge transfer

- Identifying and suggesting appropriate work-flow model for processes

- Creating schedules of deliveries (In Case Of Projects)

- Developing a project plan (In Case Of Projects)

- Driving and implementing changes - ensuring process improvements (Re-engineering)

- Liaising with onshore to Analyze business trends, forecasting and planning based on the business trends

- Transitioning - Coordinating and planning with transition department and providing support in terms of expertise

- Creating and presenting OBR's, QBR's & MPR's every month and quarterly.

- Creating and sending monthly reports to senior management

Reports :

- Creating and presenting month and quarterly report to clients

- Creating and sending Daily, weekly & monthly reports to senior management

Requirements :

To be considered for this position, applicants need to meet the qualifications listed in this posting.

Mandatory Skill Sets

- Strong Domain Knowledge in US healthcare Insurance (claims adjudication preferred on COSMOS Platform)

- Excellent project and team management skills.

- Expertise in Six Sigma methodology [preferred]

- Strong Domain Knowledge

- Ability to manage client relationships

- Good client interfacing skills

- Strong leadership skills, interpersonal skills and communication skills in a team environment.

- Discipline in defining and meeting customer & project requirements.

- Strong problem solving skills.

- Ability to prioritize and manage multiple project/programs with limited and shared resources.

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