Deputy Manager (Claims)

MDI NetworX LLC.; Pune District; On-site; INR 1,800,000 - 3,200,000; Full time

Job summary

MDI NetworX LLC. in Pune, India is seeking a senior operations professional to manage service delivery and a 20+ member team focused on US healthcare claims processing. You will drive quality, productivity, and compliance while guiding program teams to resolve issues and mitigate risks.

The role emphasizes process improvement, stakeholder engagement, and leadership development within a fast-paced payer operations environment.

Qualifications

• 10+ years in payer-side operations, preferably US healthcare claims processing.
• Strong ability to manage teams, drive performance, and develop future leaders.
• Excellent verbal and written communication for stakeholder engagement.

Responsibilities

• Assist in managing service delivery schedules per SOW.
• Monitor support functions to meet SLAs.
• Oversee 20+ resources for claims processing and US healthcare operations.
• Identify and implement training to enhance team skills.
• Ensure quality, productivity, and regulatory compliance.
• Support scope, time, quality, budget management with transparent communication.
• Build a high-performing team aligned with best practices.
• Participate in program teams to resolve issues and mitigate risks.
• Analyze interdependencies between workstreams and impact of changes.
• Drive SLA improvements and optimize production plans for TAT.
• Review trends in client satisfaction, productivity, accuracy, and efficiency.
• Adhere to organizational policies and regulatory compliance.
• Foster a culture of collaboration and continuous learning.
• Lead process improvement initiatives and automation efforts.

Skills

Leadership

Communication

Problem-solving

Process improvement

Stakeholder management

Job description

• 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.

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.