Manager Quality Assurance and Process Excellence

Cotiviti; Pune District; On-site; INR 3,000,000 - 5,000,000; Full time

Job summary

Cotiviti in Pune is seeking an experienced Manager Quality Assurance and Process Excellence to lead QA initiatives across healthcare operations, including claims, billing, and coding. The role focuses on driving transactional quality, process improvement, training effectiveness, compliance, and operational excellence.

The ideal candidate has 10+ years in quality management within healthcare, plus 3–4 years of people management, with strong leadership and stakeholder management skills.

Qualifications

• 10+ years of experience in Quality Management within Healthcare Operations.
• 3-4 years of people management experience.
• Strong knowledge of Claims, Billing, Coding, and regulatory compliance.
• Experience with Lean, Six Sigma, or Kaizen process improvement.
• Excellent analytical and stakeholder management skills.

Responsibilities

• Lead and manage the Quality Assurance team to meet quality standards and client SLAs.
• Conduct audits, quality reviews, calibration sessions, and provide feedback.
• Analyze quality metrics and drive CAPA (corrective actions).
• Lead Lean/Six Sigma / Kaizen initiatives for process improvements.
• Develop and deliver quality training programs.
• Collaborate with Operations, Compliance, and Client teams to improve service delivery.

Skills

Leadership

Stakeholder management

Data analysis

Problem solving

Communication

Education

Bachelor's degree

Tools

Lean Six Sigma

Quality management systems

Job description

Manager Quality Assurance and Process Excellence

Location: Pune

Experience: 10+ Years in Quality Management | 3-4 Years in Team Management I Must be Quality Manager for 2 Years

Job Summary

We are looking for an experienced Manager Quality Assurance and Process Excellence to lead quality assurance initiatives within healthcare operations. The role is responsible for driving transactional quality, process improvement, training effectiveness, compliance, and operational excellence. The ideal candidate should have experience in healthcare processes such as claims, billing, coding, or related operations, along with strong leadership and stakeholder management skills.

Key Responsibilities

• Lead and manage the Quality Assurance team to ensure adherence to quality standards and client SLAs.
• Conduct audits, quality reviews, calibration sessions, and provide actionable performance feedback.
• Analyze quality metrics, identify trends, and drive corrective and preventive actions.
• Lead process improvement initiatives using Lean, Six Sigma, Kaizen, or similar methodologies.
• Develop and deliver quality and process-related training programs.
• Collaborate with Operations, Compliance, and Client teams to improve service delivery and customer satisfaction.
• Manage quality escalations and ensure timely resolution.
• Drive continuous improvement through data-driven decision-making and root cause analysis.
• Mentor, coach, and develop team members.

Required Qualifications

• Graduate with all academic qualifications completed.
• 10+ years of experience in Quality Management within Healthcare Operations.
• Minimum 3-4 years of people management experience.
• Strong knowledge of healthcare processes such as Claims, Billing, Coding, and Regulatory Compliance.
• Experience in process improvement methodologies such as Lean, Six Sigma, or Kaizen.
• Excellent analytical, communication, stakeholder management, and problem-solving skills.

Preferred Qualifications

• Six Sigma Green Belt/Black Belt, CQM, or equivalent Quality Certification.
• Experience with quality management systems, reporting, and analytics tools.
• Knowledge of HIPAA, HITECH, and healthcare compliance standards.
• Experience working with global teams across India and the US.

Key Competencies

• Leadership & Team Development
• Quality Management & Auditing
• Process Improvement
• Data Analysis & Root Cause Analysis
• Stakeholder Management
• Training & Coaching
• Change Management
• Operational Excellence