Healthcare Claims Management Director

23 hours ago


Pune, Maharashtra, India IN003 Mercer Consulting India Private Limited Full time
Job Description

This is a hybrid role that involves managing the Healthcare claims management teams, which includes setting direction, communicating with senior leadership and teams, integrating and partnering with onshore management, creating execution frameworks, and delivering strategic outcomes.

Key Responsibilities:
  • Lead the team directly in managing day-to-day activities on the operations floor.
  • Participate actively in client meetings and ensure timely and high-quality delivery.
  • Manage resource planning and control any variations in capacity plans.
  • Analyze SLA discussions for the teams and ensure team performance as per agreed standards (SLA).
  • Ensure smooth handover/transition of new clients to the Ops team.
  • Conduct detailed RCA of any escalation and ensure a strong mitigation plan.
  • Manage huge data sets and validate/reconcile data from multiple data files to get the desired output.
  • Drive the culture of First Time Right and ensure effective/accurate SLA/process level/client reporting.
  • Manage client expectations and provide timely updates to management and onshore counterparts.
Requirements:
  • Graduation/post-graduation in any stream.
  • Minimum of 10+ years' experience in a large professional organization in Healthcare Claims processing/managing huge data sets, including data reconciliation, enrolment processes for client employees, insurance billing management, etc.
  • Excellent written and verbal communication skills.
  • Should have managed managers for 2-3 years.
  • Proficient in handling difficult client situations.
  • Lead and derive strategic solutions to client needs.
  • Contribute in defining roles and responsibilities for Teams.
  • Exhibited good knowledge of Quality tools like Six Sigma, Kaizen, and LEAN through projects completed.
  • Hands-on with Project Management - should have led strategic initiatives/projects.
  • Proven expertise in managing/leading migrations and ability to set up new teams with reference to ops and people practices.
  • Excellent organization and time management skills, including the ability to prioritize and adhere to timelines.
  • Excellent interpersonal skills and a commitment to providing excellent client services.
What makes you stand out?
  • Well-developed delivery management skills with experience in a globally matrixed, multi-geography, multi-cultural offshore service delivery environment.
  • Exceptional communication skills.
  • Executive presence that conveys composure and confidence in all situations.
  • Strong analytical, research, and problem-solving skills with attention to detail.
Why join our team?

We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients, and communities. We help you be your best through professional development opportunities, interesting work, and supportive leaders.

The estimated salary for this position is ₹1,500,000 - ₹2,500,000 per annum, depending on experience and qualifications.



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