Manager - Payer Operations - Healthcare Domain - BPO

Manager - US healthcare - Payor Operations (US rotational shift role)

Summary :

- Operations Managers oversee employees and activities towards the Account

- To execute day to day planning of daily deliverables as per SLA

- Ensuring availability of agents on the floor

- To ensure required service level agreements are met, both in terms of volumes and quality

- Ensure team members are rightly motivated to deliver their best

- To help the team in delivering superior customer service consistently and act as a conduit between front liners and management.

Roles and Responsibilities :

1. DELIVERY MANAGEMENT :

a. SERVICE delivery execution as per day to day planning

b. RESOLUTION of issues proactively with customers

c. REPORTING ON METRICS to the concerned stakeholders

- Transition Planning and Coordination

- Identifying Value additions and Process Improvement Initiatives

- Process Metrics review with the senior management and the team

- Adherence to company policies

- Reporting the financial metrics dashboard to the internal management team

- Reporting the process performance through the Roadmap review

- FTE Capacity Planning Vs Forecasted workload/volumes with clients

- Identify potential business growth opportunities

- Define and review KRA's for Process Managers

- Manages day-to-day operations of the Unit, including attendance, attrition and outages, to minimize customer impact

- Review Customer Escalations and Provide Effective solutions

- Ensuring the accuracy of transactions and billable hours.

- Ensuring complete responsibility of the process related deliverables

- Consolidating the invoicing details for client's approval

- Review and Report Project updates to senior management.

- Handling client escalations Identifying, recommending and implementing ways to increase the productivity and the quality of the team

- Ensuring the process meets the defined Service Levels

- ISO and HIPAA compliance.

- Creating Growth Path/Succession Planning for the process

- Effective Resource Utilization

- Define and review KRA of Leads and AMs

- Manages day to day Operations

- Control Absenteeism and Attrition in the Process

- Timely reporting of deliverables like Performance Incentive, Internal Dashboards

- 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

- Is able to identify problems and take decisions independently

- Provides solutions to individual and organizational challenges

- Co-ordinate on Process Quality requirements

- Driving Perfect Service

- Driving Formula one and other Developmental Programs for the team

- Identifying, recommending and implementing ways to increase the productivity and the quality of the team

2. PEOPLE MANAGEMENT :

- Managing Self

- Identify and participate in training / developmental programs

- Managing & Inspiring others

- Coaches and mentors AMs & DMs

- Hiring as per the process requirements

- Handle skip level meetings for the processes

- Grooming and creating back-ups for the Managers.

Desired Skills and Abilities :

- US health care (ERISA/HIPAA/State Mandates)

- Process SLA

- People Management

- Feedback and Counseling

- Presentation

- Coaching and Mentoring

- Operations planning techniques and execution capabilities

- Grooming and Business Email Etiquettes

- Working Knowledge of MS Office

- Good written and verbal communication skills (write, read and speak English for business )

- Customer service and conflict resolutions skills

- Has the potential to gain trust and rapport building

- Awareness of quality standards like ISO & ISMS

- Analytical and problem solving skills

- (Good analytical, numerical ability and logical reasoning)

- (Comprehending Ability and Decision Making)

- Mentoring and coaching with active listening skills, interaction skills

- Good telephone etiquette ( client calls related ) as applicable