AO Clinical Claims Team Lead — Operations & Quality

Sutherland Global; Taguig; Hybrid; PHP 1,200,000 - 2,000,000; Full time

Job summary

Sutherland Global is seeking a Team Manager to lead USRN Clinical Claims Associates/Specialists supporting Accident & Occupational claims. You will drive operational excellence, coach staff, monitor productivity, quality, and compliance while partnering with HR and clients to meet service levels.

You will ensure accurate claims processing, provide clinical guidance, and foster a high-performance culture focused on continuous improvement and patient outcomes. English communication skills required.

Qualifications

• Active USRN license.
• BSN or equivalent nursing qualification.
• 3–5 years of clinical nursing experience.
• 2+ years of people management experience.
• Strong English verbal and written communication.
• Knowledge of medical terminology and healthcare processes.

Responsibilities

• Manage daily operations of assigned clinical claims teams.
• Monitor productivity, quality, and turnaround time targets.
• Lead performance reviews and coaching sessions.
• Ensure HIPAA, data privacy, and client requirements compliance.
• Maintain client relationships and provide timely updates.
• Identify process improvements and drive change initiatives.

Skills

USRN license

BSN

Clinical nursing

Leadership

English communication

Analytics

Education

BSN or equivalent nursing qualification

Job description

Sutherland Global is seeking a Team Manager to lead USRN Clinical Claims Associates/Specialists supporting Accident & Occupational claims. You will drive operational excellence, coach staff, monitor productivity, quality, and compliance while partnering with HR and clients to meet service levels.

You will ensure accurate claims processing, provide clinical guidance, and foster a high-performance culture focused on continuous improvement and patient outcomes. English communication skills required.