Healthcare Operations Director

13 hours ago


Hyderabad, Telangana, India People Impact Full time

Healthcare Operations Director

We are seeking a highly experienced Healthcare Operations Director to join our team at People Impact. In this role, you will be responsible for driving strategic guidance for payer operations.

The key responsibilities include:

  • Strategic Guidance

- Drive strategy for payer operations, focusing on claims, member engagement, provider relationships, and cost management.

- Implement innovative solutions using AI, automation, and analytics to optimize processes.

- Stay abreast of industry trends and regulatory updates (e.g., CMS, ACA) to align strategies.

Enablement of Technology

- Collaborate with tech teams to deploy advanced platforms for claims adjudication, payment integrity, and member engagement.

- Utilize predictive analytics to enhance risk management and optimize value-based payment models.

- Ensure compliance and interoperability with standards like HIPAA, FHIR, and EDI.

Leadership

- Build and lead high-performing, cross-functional teams, fostering collaboration and accountability.

- Champion a culture of innovation and continuous improvement while mentoring team members.

Collaboration Among Stakeholders

- Partner with providers, employers, and regulatory agencies to strengthen relationships and drive service excellence.

- Align payer strategies with population health and care delivery initiatives.

Financial Supervision

- Manage budgets to ensure cost-efficiency and ROI while identifying opportunities to reduce MLR and enhance profitability.

The ideal candidate should possess:

  • 25+ years of healthcare payer experience.
  • Expertise in claims management, value-based payments, and regulatory compliance (CMS, HIPAA).
  • Proficiency with payer tech platforms, analytics, and CRM tools.
  • Exceptional strategic, problem-solving, and executive communication skills.

Estimated salary: $240,000 - $290,000 per year.



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