Urwah Admin

Sagility

<div><h2 class="jobSectionHeader"><b>About Sagility</b></h2>
<div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p>Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.</p></div></div></div></div></div></div></div></div></div></div></div></div></div></div><p></p><div><div><div><div><div><div><div><p><b>
Job title:</b></p></div></div></div></div></div></div></div>
Director - Operations<p></p><div><div><div><div><div><div><div><p><b>
Job Description:</b></p></div></div></div></div></div></div></div><p>
Job Title Director Claims Operations &ndash; US1 Reporting to Senior Director/AVP Location Bangalore Working Hours/ Days 9 Hours / 5 Days a Week Shift Night Shift (4pm-1am) 9hr shift (There can be fortnightly/ monthly call between 06:30am-2pm IST)<br>
Team Size 300 FTE+ Company URL www.sagilityhealth.com<br>
Mandatory: Ideal candidature would be 14-18 YEARS OVERALL EXPERIENCE WITH MIN 10+ YEARS IN US HEALTHCARE PAYER OPERATIONS.<br>
Desired skills and qualification<br>
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 A Bachelor degree or equivalent qualification.<br>
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 RPA/ Analytics Certification preferred<br>
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 Preferably Lean/ Six Sigma Certified<br>
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 Ideal candidature would be 14-18 YEARS OVERALL EXPERIENCE WITH MIN 7- 10 YEARS IN US healthcare Payer Operations.<br>
As a Strategic Thinker:<br>
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 Identifying Transformational Value Creation via RPA and Analytics offerings.<br>
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 Value additions and Process Improvement Initiatives.<br>
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 Account Management<br>
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 Program/ Business Budget and Supply Planning<br>
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 P&amp;L Management (Revenue management, Cost Optimization, Improvements)<br>
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 Service Quality Management<br>
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 Client Communications Management<br>
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 Provide strategic direction to assigned lines of businesses<br>
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 Take leadership role in migration to new case management database.<br>
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 Stakeholder Management<br>
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 Statutory Audit &amp; Compliance Adherence (HIPAA/ISO/ISMS)<br>
As Driving Results:<br>
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 Track program performance and its impact on the financial goal<br>
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 Creating Growth Path/Succession Planning for the process<br>
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 Effective Resource Utilization<br>
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 Define and review KRA of Deputy Manager, Manager, Senior Manager, AGM<br>
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 Identify and participate in training / developmental programs.<br>
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 SLA &amp; Metrics Management<br>
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 Responsible for monthly/quarterly/annual performance appraisals of employees in the vertical.<br>
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 Support development of program policies, rules, protocols, handbooks, and forms for all program components<br>
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 Identify opportunities to streamline business processes and systems.<br>
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 Represent the company and actively participate in operational reviews, MBR s/QBRs<br>
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 Timely reporting of deliverables like Performance Incentive, Internal Dashboards<br>
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 Identifying, recommending, and implementing ways to increase the productivity and the quality of the team.<br>
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 Attend to Process Escalation and provide effective solutions<br>
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 Responsible for Balance Score Card and its parameters<br>
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 Attend to Client calls, Stat us Meeting and Client Feedback.<br>
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 Review and Regulate SOP<br>
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 Can identify problems and take decisions independently<br>
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 Provides solutions to individual and organizational challenges<br>
As a Partner with Clients:<br>
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 Delivering Highest Level of Service Delivery Standards<br>
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 Exemplify Passion for excellence.<br>
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 Design and Drive Business/Program Excellence Initiatives<br>
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 Voice of the Organisation.<br>
Lead People:<br>
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 Inspirational Leadership<br>
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 Lead from the front as the SME of the Business/ Program<br>
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 Design &amp; Drive People Metrics<br>
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 Promoting Diversity &amp; Inclusion as per Organisational Culture<br>
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 Mentoring &amp; Coaching Operational &amp; Leadership values<br>
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 Improve employee retention and enhance employee engagement.<br>
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 Succession Planning<br>
Primary Skills:<br>
 Must be working with U.S based Business / Customers in U.S Shifts<br>
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 Statutory Audit &amp; Compliance Adherence (HIPAA/ISO/ISMS)<br>
 Minimum 10+ years of work experience in end to end Claims Adjudication domain<br>
 Business Excellence/ Improvements Projects<br>
 Managed a large and Complex Delivery Team<br>
 Minimum Span Management should be 300+ FTE.<br>
 Client &amp; Stakeholder Management<br>
 P&amp;L Management<br>
Secondary Skills:<br>
 Preferable Onshore Transition experience<br>
 Coaching and Mentoring<br>
 Excellent Communication Skills<br>
 Excellent Analytical skills<br>
 Excellent People Management<br>
 Excellent Presentation Skills</p><p></p><div><div><div><div><div><div><div><p><b>
Location:</b></p></div></div></div></div></div></div></div>
BangaloreIndia</div></div>

Director - Operations

Join Sagility and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Sagility

About Company

Director - Operations