Delivery Head - Healthcare - Insurance process

Datamatics Global Service Ltd,; Nashik District; On-site; INR 1,800,000 - 3,000,000; Full time

Job summary

Datamatics Global Service Ltd is seeking a Delivery Head for Healthcare BPO/RCM in Nashik. The candidate will lead end-to-end delivery operations, ensuring accuracy, quality, and client satisfaction for international accounts. Experience in 24x6 operations, healthcare RCM, and strong leadership is essential.

The role requires managing large teams, driving process improvements, and stakeholder communications with global clients, while maintaining compliance and data security standards.

Qualifications

• 12 to 16 years of experience in BPO/ITES with 3+ years in Delivery Head or senior operations leadership.
• Strong hands-on experience in US Healthcare RCM, medical billing, claims processing, and payer operations.
• Experience managing large teams of 150+ FTEs in 24x6 or 24x7 operations.
• Deep knowledge of HIPAA, HITECH, SLA management, operational metrics, and client relationship management.

Responsibilities

• Lead end-to-end healthcare BPO delivery operations with focus on excellence, productivity, accuracy and service delivery.
• Oversee RCM processes including medical billing, claims processing, adjudication and document indexing.
• Drive SLA/KPI management (TAT, First Pass Clean Claim Rate, charge capture, quality, productivity).
• Manage 24x6 operations, shift planning, workforce deployment and resource utilization.

Skills

Leadership

US Healthcare RCM

Team leadership

Stakeholder management

Problem solving

Communication

Process improvement

Education

Bachelor or Master in Business/Commerce/Information Systems

Six Sigma Green Belt or Black Belt

Job description

Job Description: Delivery Head Healthcare BPO / RCM

Location: Nashik, Work From office only.
Industry: Healthcare BPO / ITES
Experience: 1216 Years

Key Roles & Responsibilities

1. Delivery Operations: Lead end-to-end healthcare BPO delivery operations, ensuring operational excellence, productivity, accuracy, and consistent service delivery.


2. Healthcare RCM Expertise: Manage transactional Revenue Cycle Management (RCM) processes, including medical billing, claims processing, claims adjudication, and document indexing.


3. Claims Processing: Oversee professional claims using HCFA-1500 and institutional claims using UB-04 forms, ensuring data accuracy and adherence to payer requirements.


4. SLA & KPI Management: Drive key performance indicators, including turnaround time (TAT), First Pass Clean Claim Rate, charge capture accuracy, quality, and productivity.


5. 24x6 Operations Management: Manage round-the-clock delivery operations, shift planning, workforce deployment, and resource utilization to ensure uninterrupted service delivery.


6. Compliance & Data Security: Ensure adherence to HIPAA, HITECH, patient data confidentiality, information security policies, and clean-desk standards.


7. Client & Stakeholder Management: Act as the primary point of contact for international clients, managing escalations, performance reviews, and strategic operational discussions.


8. Performance Improvement: Conduct root cause analysis (RCA), implement corrective and preventive actions, and drive continuous improvement initiatives to reduce errors and improve efficiency.


9. Team Leadership: Lead and develop large delivery teams of 150+ FTEs through performance management, coaching, succession planning, and leadership development.


10. Capacity & Workforce Planning: Partner with Workforce Management (WFM) to optimize staffing, multi-skilling, capacity planning, and resource allocation in line with business volumes.


11. Financial & P&L Management: Manage account financial performance, operating costs, revenue per seat, billing utilization, productivity, and operational margins.


12. Business Reviews & Reporting: Lead weekly performance reviews, Monthly Business Reviews (MBRs), and Quarterly Business Reviews (QBRs), presenting operational insights and action plans.


13. Talent Retention & Engagement: Drive employee engagement, retention, and career development initiatives while managing attrition and maintaining a strong leadership pipeline.


14. Process Governance & Risk Management: Establish robust process controls, audit readiness, documentation standards, and risk mitigation measures to maintain operational stability.


15. Business Growth & Transformation: Identify opportunities for process optimization, automation, scalability, and service delivery enhancement to support account growth and client satisfaction.

Candidate Profile :-

• 12 to 16 years of experience in BPO/ITES, including at least 3 years in a Delivery Head or Senior Operations leadership role.


• Strong hands-on experience in US Healthcare RCM, medical billing, claims processing, and payer operations.


• Proven experience managing large teams of 150+ FTEs in 24x6 or 24x7 operations.


• Strong knowledge of HIPAA, HITECH, SLA management, operational metrics, and client relationship management.


• Bachelor's or Master's degree in Business, Commerce, Information Systems, or a related discipline.


• Six Sigma Green Belt or Black Belt certification will be an added advantage.


• Excellent leadership, analytical, communication, stakeholder management, and problem-solving skills.