Connect & Heal - Senior Operations Manager - Medical Claim Digitization

Role Purpose :

The Senior Operations Manager will be responsible for leading end-to-end medical claim digitization operations across multiple accounts/projects, ensuring achievement of business objectives, client SLAs, TAT, quality, productivity, profitability, and operational excellence.

The role requires ownership of large-scale operations, client governance, workforce strategy, process transformation, technology adoption, and capability building to support business growth.

Key Responsibilities :

- Lead and manage end-to-end medical claim digitization operations across multiple clients and processes.

- Drive operational strategy to deliver sustainable improvements in TAT, quality, productivity, and profitability.

- Establish scalable operating models to support business growth and changing client requirements.

- Own operational governance and business continuity planning.

- Serve as the senior operational interface for client leadership teams.

- Lead governance forums, business reviews, and operational discussions.

- Drive client satisfaction through delivery excellence and proactive stakeholder management.

- Support commercial discussions including pricing, SOW reviews, penalties, change requests, and operational feasibility.

- Partner with business teams for account growth, renewals, and expansion opportunities.

- Ensure achievement of committed SLAs including :

i. Turnaround Time (TAT)

ii. Quality and Accuracy

iii. Productivity

iv. Capacity Utilization

v. Cost Efficiency

- Monitor daily operations and proactively manage risks impacting delivery.

- Drive RCA and CAPA for operational deviations.

- Own manpower planning based on forecasted and actual business volumes.

- Build hiring plans and succession pipelines.

- Drive shift planning, roster management, leave governance, and utilization optimization.

- Ensure operational readiness for seasonal spikes and new implementations.

- Build quality frameworks to ensure high accuracy in medical claim digitization.

- Ensure adherence to client guidelines, contractual obligations, IRDAI requirements, and information security standards.

- Lead internal and external audits.

- Drive continuous improvement programs to enhance quality outcomes.

- Lead Operations Managers, Team Leaders, Quality teams, Trainers, and support functions.

- Drive leadership capability and succession planning.

- Build a performance-oriented and accountable culture.

- Coach teams on operational excellence and client management.

- Present performance reviews to senior leadership and clients.

Track :

i. TAT Compliance

ii. Accuracy %

iii. Productivity

iv. Forecast vs Actual Volumes

v. Attrition

vi. SLA Achievement

vii. Customer Satisfaction

viii. Financial Performance

Key Performance Indicators (KPIs) :

- SLA & TAT Achievement

- Quality / Audit Scores

- Productivity per FTE

- Forecast Accuracy

- Attrition & Engagement

- Escalation Closure

- Automation Adoption

Required Qualifications :

- Graduate / Postgraduate (Healthcare Management / Operations / Business preferred)

- MBA preferred