Senior Manager - US Healthcare Operations (Payer/Eligibility)

Hexaware Technologies; Navi Mumbai; On-site; INR 1,200,000 - 2,000,000; Full time

Job summary

Hexaware Technologies in Navi Mumbai seeks an experienced Operations Manager to oversee back-office healthcare processes, drive revenue targets, and maintain high service quality across a large 300+ member team.

The role demands strategic planning, crisis management, and strong account leadership, with focus on SLA adherence, process improvement, and collaboration with senior management to align operations with business goals.

Qualifications

• Experience as Operations Manager in healthcare processes (minimum 3 years).
• Knowledge of US Payer Healthcare Eligibility/Enrollment and Claims.
• Understand architecture of inbound/outbound and electronic eligibility processes.
• Lean/ Six Sigma exposure with certifications preferred.

Responsibilities

• Lead a team of 100+ across multiple accounts, ensuring SLA compliance.
• Drive revenue targets and service quality through operational excellence.
• Monitor performance metrics and implement quality assurance measures.
• Collaborate with senior management to align operations with business goals.
• Manage crisis situations and drive problem-solving actions.
• Foster positive team culture and maintain staff engagement.

Education

Graduate degree

Job description

Role

The incumbent will oversee operations in back-office environment, ensuring the achievement of revenue targets and maintaining high levels of service quality. The role requires strategic planning, crisis management, and effective account management. The individual will be responsible for managing a large team across different accounts, ensuring adherence to SLAs, and implementing quality assurance measures. This position demands a seasoned professional with experience in processes for US-Healthcare industry, capable of leading operational excellence in a dynamic, fast-paced setting.

Job Responsibilities

• Manage and lead a team of 100+ members with a direct span of control of 2 4 leads.
• Ensure SLA maintenance and quality assurance across operations.
• Handle crisis management and problem-solving activities.
• Collaborate with senior management to align operations with business goals.
• Monitor and analyze performance metrics to drive improvements.
• Foster a positive work environment and team culture

Desired

• Work experience in a US Payer Healthcare Eligibility/Enrollment program apart from Claims experience.
• Understands the technical architecture in the operation model for Inbound, Outbound and Electronic Eligibility processes
• Been part of the responsibilities to improve the process at conceptual and technical level.
• D inimum 3 years of experience as a Operations Manager in healthcare processes.

Criteria

• 12-16 years experience, managing a team size of 300+.
• Graduate from recognized/full time college.
• Exposure to Six Sigma/Lean preferably with YB/GB certification.
• Proven track record in account management, process/SLA management and revenue.
• Strategic planning and crisis management skills.
• Quality management.

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