Operations Manager -Healthcare (RCM and Denial management)

HCL is hiring for Operations Manager with experience with Healthcare RCM and Denial management process.

Interested candidates, please share your resume to ashwin-k@hcltech.com

JOB SUMMARY

This position is responsible for day-to-day management of the staff in support of (HCL Clients) healthcare business operations overseeing all back office and claims processing activities. The position is also responsible for definition and application of business rules, work queue assignment & monitoring, transaction monitoring & processing, In addition, this position is responsible for identifying, recommending and implementing process & system solutions with a focus on a great customer experience and a cost-effective, high-performing operation

Essential Duties and Responsibilities

• Manage day-to-day operations and directs the team responsible for Healthcare RCM back office/transaction management activities
• Manage and meet performance targets for average handle time, Client SLA, quality , outcome measures and customer satisfaction
• Manage a group of Team Leads responsible for management of back office agents and SMEs.
• Coordinate with internal support functions such as Quality, WPC, Training, Admin, HR
• Ensure quality and efficiency measures are met within the team and in accordance with service level agreements
• Provide coaching and feedback to direct report positions to ensure satisfactory performance levels
• Use business tools and advanced Healthcare RCM knowledge to identify problem areas and document business requirements
• Identify and recommend operational and technological tools to improve efficiency
• Work with operations and information technology personnel to resolve issues and improve operational efficiency
• Establish and maintain effective work procedures
• Review, assess and identify coaching & training needs to provide staff with necessary skills and knowledge
• Understand, communicate and implement strategic direction and leadership for HCL to ensure consistent and cohesive business objectives and to enhance customers experiences in both a regulated and a competitive market.
• Plan and monitor operations initiatives to improve the efficiency and effectiveness of the back office
• Review and ensure processes are in compliance with internal policies and external regulations.
• Respond to escalated issues regarding performance and quality.
• Coordinate, participate, and/or manage multiple projects assigned by senior management, providing input on operations related matters.
• Interface and coordinate with various stakeholders
• Responsible for meeting the revenue targets and also the Margins based on business plan.

EDUCATION/EXPERIENCE

The minimum education requirements are:

• Bachelors degree in any stream (may substitute two years of relevant experience per one year of required education)

The minimum experience requirements are:

• Eight to Twelve years of relevant work experience-: US Healthcare RCM experience (preferably Provider AR management) Min. 3 Yrs of Managerial exp. in similar rolls for E3.1
• Five years of experience supervising professional workgroups (SME / team leaders)
• Experience in managing customer/supplier relationships.

SKILLS AND COMPETENCIES

• Exceptional leadership skills, including the ability to manage through a shared vision and path to success
• Ability to create, communicate and manage SLA metrics that support operational targets
• Excellent problem solving skills and ability to use good judgment to make decisions
• Possess exceptional people management skills enabling effective interaction with internal, external customers, employees, peers, and management
• Strong analytical skills and desire to research problems to seek resolution
• Exceptional verbal and written communication skills
• Exceptional customer service abilities to handle difficult customers on calls, or present during review meetings
• Proficiency in Microsoft Office suite (Excel, word and powerpoint)
• Work effectively in a team environment
• Strong time management and organizational skills

Interested candidates, please share your updated resume to ashwin-k@hcltech.com

Please remember this is only for US healthcare(BPO) and who have experience in this domain(RCM & Denial Management)