Deputy Manager (Claims)

MDI NetworX; Maharashtra; On-site; INR 1,800,000 - 3,000,000; Full time

Job summary

MDI NetworX in Pune seeks an experienced leader to drive operations excellence in US healthcare claims processing. You will oversee 20+ team members, manage service delivery against SOWs and SLAs, and push improvements in quality, productivity, and compliance.

The role demands strong stakeholder communication, problem solving, and automation-led process optimization across multiple functions. Based in Pune, the role focuses on delivering reliable, high-quality outcomes.

Qualifications

• 10+ years in payer-side US healthcare claims operations.
• Leadership experience managing large teams.
• Excellent verbal and written stakeholder communication.
• Proactive problem solving and issue resolution.
• Automation and process workflow optimization experience.
• Strong cross-functional collaboration across departments.

Responsibilities

• Manage service delivery schedules per SOW and SLAs.
• Oversee 20+ resources in claims processing and US healthcare ops.
• Identify training programs to upskill the team.
• Drive SLA improvements and optimize production plans for TAT.
• Review client satisfaction, productivity, accuracy metrics.
• Ensure compliance with regulations and company policies.
• Lead program teams to resolve issues and mitigate risks.
• Collaborate with Quality, Admin, HR, and Product Delivery to ensure seamless operations.

Skills

Leadership

Communication

Problem-Solving

Process Improvement

Stakeholder Management

Job description

Viman Nagar Pune

Key Responsibilities

• Assist in managing service delivery schedules and commitments as per the Statement of Work (SOW).
• Monitor key support functions to ensure optimal service delivery and adherence to SLAs.
• Oversee a team of 20+ resources, ensuring high performance in claims processing and US healthcare operations.
• Identify and implement training programs to enhance team skills and domain knowledge.
• Ensure operational efficiency with a focus on quality, productivity, and compliance.
• Support scope, time, quality, and budget management while maintaining transparent communication.
• Assist in building a high-performing team aligned with best practices and industry standards.
• Participate in program teams, proactively resolving project issues and mitigating risks.
• Analyze interdependencies between workstreams and assess the impact of process changes.
• Continuously drive SLA improvements and optimize production plans to ensure TAT compliance.
• Review and refine statistical trends related to client satisfaction, productivity, accuracy, and efficiency.
• Ensure adherence to organizational policies, objectives, and regulatory compliance.

Operational Excellence

• Assist in managing service delivery schedules and commitments as per the Statement of Work (SOW).
• Monitor key support functions to ensure optimal service delivery and adherence to SLAs.
• Oversee a team of 20+ resources, ensuring high performance in claims processing and US healthcare operations.
• Identify and implement training programs to enhance team skills and domain knowledge.
• Ensure operational efficiency with a focus on quality, productivity, and compliance.
• Support scope, time, quality, and budget management while maintaining transparent communication.
• Assist in building a high-performing team aligned with best practices and industry standards.
• Participate in program teams, proactively resolving project issues and mitigating risks.
• Analyze interdependencies between workstreams and assess the impact of process changes.
• Continuously drive SLA improvements and optimize production plans to ensure TAT compliance.
• Review and refine statistical trends related to client satisfaction, productivity, accuracy, and efficiency.
• Ensure adherence to organizational policies, objectives, and regulatory compliance.

People Management

• Conduct periodic check-ins, one-on-ones, and skip-level meetings to assess employee engagement.
• Act as a bridge between leadership and employees, escalating unresolved concerns to senior management.
• Foster a culture of collaboration, accountability, and continuous learning within the team.

Process Improvement & Strategic Initiatives

• Work closely with Quality, Admin, HR, and Product Delivery teams to ensure seamless operations.
• Identify and implement process improvement initiatives to enhance efficiency and service quality.
• Drive automation and digital transformation efforts to streamline workflows.
• Lead floor-level engagement initiatives to boost employee satisfaction and reduce attrition.

Skills & Qualifications

• Experience: 10+ years in Payer-side operations, preferably within US healthcare claims processing.
• Leadership: Strong ability to manage teams, drive performance, and develop future leaders.
• Communication: Excellent verbal and written communication for stakeholder engagement.
• Problem-Solving: Proactive approach to issue resolution and process enhancements.
• Process Improvement: Proven experience in automation, workflow optimization, and operational efficiency.
• Stakeholder Management: Ability to collaborate effectively across multiple departments and functions.