Clinical Claims Team Lead – AO Pooling

SmartRecruiters, Inc.; Taguig; On-site; PHP 1,200,000 - 1,800,000; Full time

Job summary

Sutherland in the Philippines seeks a Team Manager for AO Clinical Claims (Pooling) to lead a USRN Clinical Claims team supporting Accident & Occupational claims. You will drive accuracy, quality, and client satisfaction while ensuring regulatory and client standards.

The role requires 3–5 years of clinical nursing experience, 2+ years in people management, and strong English communication. Manage operations, coach teams, and implement process improvements in a health‑care BPO setting.

Qualifications

• Active and unrestricted US Registered Nurse (USRN) license.
• Bachelor's Degree in Nursing (BSN) or equivalent nursing qualification.
• Minimum 3-5 years of clinical nursing experience in healthcare settings.
• Minimum 2 years of people management experience in healthcare operations or related BPO/claims.
• Strong English communication skills (verbal and written).
• Knowledge of HIPAA and healthcare processes.

Responsibilities

• Manage daily operations of assigned clinical claims teams.
• Monitor achievement of productivity, quality, accuracy, and turnaround targets.
• Coach, develop, and conduct performance reviews with staff.
• Ensure adherence to client processes, policies, and SOPs.
• Lead process improvement and change management initiatives.
• Maintain strong client relationships through regular updates and delivery.

Skills

USRN license

English communication

People management

Clinical nursing knowledge

Education

BSN or equivalent nursing degree

Tools

Lean Six Sigma Certification

Job description

Sutherland in the Philippines seeks a Team Manager for AO Clinical Claims (Pooling) to lead a USRN Clinical Claims team supporting Accident & Occupational claims. You will drive accuracy, quality, and client satisfaction while ensuring regulatory and client standards.

The role requires 3–5 years of clinical nursing experience, 2+ years in people management, and strong English communication. Manage operations, coach teams, and implement process improvements in a health‑care BPO setting.