Deputy Manager (Claims)

MDI NetworX; Pune District; On-site; INR 1,500,000 - 2,000,000; Full time

Job summary

MDI NetworX LLC. is seeking a seasoned professional to manage healthcare operations in Pune, India. This role demands over 10 years of experience in Payer-side operations, specifically in US healthcare claims processing, combined with strong leadership skills to oversee a team of 20+ resources.

The successful candidate will ensure optimal service delivery and compliance while driving process improvements and enhancing team capabilities. Strong communication and stakeholder management skills are essential.

Qualifications

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

Responsibilities

• Manage service delivery schedules and commitments as per the Statement of Work (SOW).
• Oversee a team of 20+ resources to ensure high performance in claims processing.
• Identify and implement training programs to enhance team skills.
• Support scope, time, quality, and budget management with transparent communication.
• Continuously drive SLA improvements to ensure TAT compliance.

Skills

Healthcare claims processing expertise

Team management

Process improvement

Stakeholder management

Automation

Job description

Key Responsibilities

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.

Recruitment Ethics at MDI NetworX: MDI NetworX never requests payment at any stage of the hiring process. Any demand for money in exchange for a job, directly or indirectly, is fraudulent and should be reported immediately to [e-mail].