AGM Payer Operations Objectives and Responsibilities of AGM Operations : 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 goals - Creating Growth Path/Succession Planning for the process - Effective Resource Utilization - Define and review KRA of Deputy Manager, Manager, Senior Manager . - 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, MBRs/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, Status 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 Organization 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 Mandatory Skills & Qualifications : Domain Skills : - Experience in Payment Integrity / Payment Recovery/ Cost Containment - Desirable - Experience in Claims Adjudication/ Processing for at least 10+ years - Experience in Pre- Authorization and Post Authorization - Desirable - Experience in Planned Services (Plan Setup/ Plan Testing)- Desirable - Experience in Denial Management -Desirable - US health care (ERISA/HIPAA/State Mandates) - Minimum 10+ years of work experience in Claims Adjudication domain - Experience in any Mailroom process (US Healthcare mailroom would be Desirable) Operational Skills : - Willing to work in flexible shifts (Mid shift) - Minimum Span Management should be 350+ FTE - Client Management - P&L Management - Awareness of Statutory Compliances like ISO, ISMS - Managed a large and Complex Delivery Team - Preferable Onshore Transition experience - Business Excellence/ Improvements Projects - Stakeholder Management Intrapersonal Skills : - Excellent Communication Skills - Excellent Analytical skills - Excellent People Management - Excellent Presentation Skills - Stakeholder Management - Coaching and Mentoring Educational Skills : - Graduation/Post Graduation Must - Lean/Six Sigma Certification is must - RPA/ Analytics Certification preferred

Chennai

Assistant General Manager - Payer Operations - Claims Adjudication Domain 

Assistant General Manager - Payer Operations - Claims Adjudication Domain  ,Job Description for Assistant General Manager - Payer Operations - Claims Adjudication Domain  in T3Cogno Private Limited in  Chennai for (14-25) years of experience. Apply Now!

Job Description for Assistant General Manager - Payer Operations - Claims Adjudication Domain  in T3Cogno Private Limited in  Chennai for (14-25) years of experience. Apply Now!