Director - Health Care Payer Delivery

To lead the Healthcare Payer Delivery Unit

Scope

This position is responsible for leading the Payer Delivery Unit. Responsibility includes providing leadership to a high performing delivery organization, anchor global transition, drive the transformation agenda across the engagements & also contribute to growth of the vertical. This position has complete p&L responsibility of the payer unit.

Skills & Competencies

- 15+ years of healthcare BPO service delivery experience - client base serviced should be Payer Only- NOT in Provider space)

- Managed U.S based payer accounts - leading National health plans or regional Blues (Not TPAs)

- Handled team of 600+ FTEs with global delivery responsibility (India, U.S, Philippines etc.)

- Strong domain exposure to Claims mgmt./adjudication, Benefit coding, Enrollment & Billing, Audits & recovery

- Basic exposure to provider or member call centre services

- Experience on leading payer platforms Facets/Trizetto, Pega & involved in robotics

- Strong grip on service delivery metrics & ability to drive productivity & quality targets

- Exposure to delivering on multiple revenue models - FTE, transaction based, Per member per month models

- Should have led operations excellence projects/continuous improvement initiatives

- Interfaced at leadership level (Director & above) at the client organization

- Led MBR, QBR for the engagement

- Demonstrated value realization through Automation & Transformation

- Exceptional communication & client interface skills

- Has driven growth in the payer segment - contributing to RFX solutions, bid defence & led client visits.