Senior Director - Operations - Healthcare Claims

Description:

Innoquest is currently looking for an experienced professional for an Senor Director Operations role for one of its clients in the Healthcare Industry, based in Indore. The ideal candidate should possess strong healthcare industry knowledge and extensive experience in operations management.

For Senior Director an ideal candidature would be 18+ years overall experience with min 10+ years in us healthcare payer operations.

Mandatory Ask:

- For Senior Director an ideal candidature would be 18+ years overall experience with min 10+ years in us healthcare payer operations.

- Candidates must come from Payer/Claims Operations from U.S Healthcare BPM/GCC backgrounds.

- Open for US shifts.

Duties and responsibilities:

- Identifying Transformational Value Creation via RPA and Analytics.

- 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).

- Track program performance and its impact on the financial goal

- Creating Growth Path/Succession Planning for the process

Elective Resource Utilization

- Define and review KRA of Deputy Manager, Manager, Senior Manager, AGM

- 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 a program components

- Identity opportunities to streamline business processes and systems

- Represent the company and actively participate in operational reviews, MBR s/QBRs/

- Timely reporting of deliverables like Performance Incentive, Internal Dashboards

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

- Attend to Process Escalation and provide effective solutions

- Responsible for Balance Score Card and its parameters

- Attend to Client calls, Stat us Meeting and Cllent Feedback, Review and Regulate SOP

- Can Identity problems and take decisions independently