General Manager Quality

AGS Health; Hyderabad; On-site; INR 3,000,000 - 6,000,000; Full time

Job summary

AGS Health is seeking a seasoned Quality leader with 15+ years in US Healthcare RCM to drive end-to-end quality programs across client engagements. You will establish frameworks, KPIs, and audit mechanisms to ensure CMS/HIPAA compliance and high performance.

You will mentor QA teams, collaborate with operations, and lead continuous improvement using Six Sigma, Lean, and data analytics, while aligning with client SLAs and strategic goals.

Qualifications

• Minimum 15 years of experience in US Healthcare (RCM - AR Operations/End to End RCM).

Responsibilities

• Lead and drive overall quality strategy across end-to-end RCM functions
• Define and implement quality frameworks, SOPs, and audit mechanisms aligned with client and regulatory standards
• Ensure compliance with CMS, HIPAA, provider guidelines, and industry regulations
• Establish strong governance models, KPIs, and quality scorecards for performance tracking
• Drive continuous quality improvement initiatives using RCA, Six Sigma, and Lean methodologies
• Identify trends in denials, errors, and audit failures and implement corrective actions
• Manage internal & external audits, ensuring audit readiness and compliance adherence
• Partner with operations teams to reduce rework, improve accuracy, and enhance first-pass yield
• Lead client quality reviews (QBRs) and act as the point of contact for quality-related escalations
• Ensure client SLA adherence, service excellence, and long-term retention
• Build and manage high-performing QA teams, including hiring, training, and capability development
• Drive a culture of quality ownership, accountability, and continuous improvement
• Leverage automation, analytics, and AI tools to improve quality monitoring and predictive insights
• Work closely with leadership on strategic initiatives, process transformation, and cost optimization

Skills

Service Delivery Leadership

Strategic thought leadership

Stakeholder Management

Problem Solving

Integrity & ethics

Self-starter

Attention to detail

Time management & multi-tasking

English proficiency

Job description

AGS Health is a leading strategic growth partner to healthcare providers across the U.S. Working alongside each client as one team, we improve revenue cycle performance by orchestrating data, AI, automation, and human expertise across every workflow. Our proven model complements customers' existing teams, technology, and processes, deploying the right capabilities to improve efficiency, strengthen financial performance, and enhance the patient financial experience. Supported by a global team of more than 16,000 clinical and revenue cycle experts across onshore, nearshore, and offshore locations, AGS Health helps customers achieve measurable results across diverse care settings and specialties.

RESPONSIBILITIES

• Lead and drive overall quality strategy across end-to-end RCM functions
• Define and implement quality frameworks, SOPs, and audit mechanisms aligned with client and regulatory standards
• Ensure compliance with CMS, HIPAA, provider guidelines, and industry regulations
• Establish strong governance models, KPIs, and quality scorecards for performance tracking
• Drive continuous quality improvement initiatives using RCA, Six Sigma, and Lean methodologies
• Identify trends in denials, errors, and audit failures and implement corrective actions
• Manage internal & external audits, ensuring audit readiness and compliance adherence
• Partner with operations teams to reduce rework, improve accuracy, and enhance first-pass yield
• Lead client quality reviews (QBRs) and act as the point of contact for quality-related escalations
• Ensure client SLA adherence, service excellence, and long-term retention
• Build and manage high-performing QA teams, including hiring, training, and capability development
• Drive a culture of quality ownership, accountability, and continuous improvement
• Leverage automation, analytics, and AI tools to improve quality monitoring and predictive insights
• Work closely with leadership on strategic initiatives, process transformation, and cost optimization

COMPETENCIES, SKILLS, AND OTHER REQUISITES

• Service Delivery Leadership
• Strategic Thought leadership to grow business.
• External and Internal Stakeholder Management
• Problem Solving and Analytical Skills
• Unflinching integrity and personal work ethics
• Self-starter who strives for self and team excellence
• Attention to detail and concern for accuracy.
• Excellent time management skills and multi-tasking ability
• Excellent written and spoken English.

PROFESSIONAL BACKGROUND

• Minimum 15 years of experience in US Healthcare (RCM - AR Operations/End to End RCM ) Experience is must.