Role Purpose:
The Senior Operations Manager will be responsible for leading end-to-end medical claim digitization operations across multiple accounts/projects, ensuring achievement of business objectives, client SLAs, TAT, quality, productivity, profitability, and operational excellence.
The role requires ownership of large-scale operations, client governance, workforce strategy, process transformation, technology adoption, and capability building to support business growth.
Key Responsibilities:
1. Strategic Operations Leadership
- Lead and manage end-to-end medical claim digitization operations across multiple clients and processes.
- Drive operational strategy to deliver sustainable improvements in TAT, quality, productivity, and profitability.
- Establish scalable operating models to support business growth and changing client requirements.
- Own operational governance and business continuity planning.
2. Client & Business Management
- Serve as the senior operational interface for client leadership teams.
- Lead governance forums, business reviews, and operational discussions.
- Drive client satisfaction through delivery excellence and proactive stakeholder management.
- Support commercial discussions including pricing, SOW reviews, penalties, change requests, and operational feasibility.
- Partner with business teams for account growth, renewals, and expansion opportunities.
3. Service Delivery Excellence
- Ensure achievement of committed SLAs including:
- Turnaround Time (TAT)
- Quality and Accuracy
- Productivity
- Capacity Utilization
- Cost Efficiency
- Monitor daily operations and proactively manage risks impacting delivery.
- Drive RCA and CAPA for operational deviations.
4. Workforce Planning & Resource Management
- Own manpower planning based on forecasted and actual business volumes.
- Build hiring plans and succession pipelines.
- Drive shift planning, roster management, leave governance, and utilization optimization.
- Ensure operational readiness for seasonal spikes and new implementations.
5. Quality, Audit & Compliance
- Build quality frameworks to ensure high accuracy in medical claim digitization.
- Ensure adherence to client guidelines, contractual obligations, IRDAI requirements, and information security standards.
- Lead internal and external audits.
- Drive continuous improvement programs to enhance quality outcomes.
8. Leadership & Team Development
- Lead Operations Managers, Team Leaders, Quality teams, Trainers, and support functions.
- Drive leadership capability and succession planning.
- Build a performance-oriented and accountable culture.
- Coach teams on operational excellence and client management.
9. Governance & Reporting
- Present performance reviews to senior leadership and clients.
- Track:
- TAT Compliance
- Accuracy %
- Productivity
- Forecast vs Actual Volumes
- Attrition
- SLA Achievement
- Customer Satisfaction
- Financial Performance
Key Performance Indicators (KPIs):
- SLA & TAT Achievement
- Quality / Audit Scores
- Productivity per FTE
- Forecast Accuracy
- Attrition & Engagement
- Escalation Closure
- Automation Adoption
Required Qualifications:
- Graduate / Postgraduate (Healthcare Management / Operations / Business preferred)
- MBA preferred
Experience:
- 8 - 10 years of overall operations experience
- Minimum 5+ years in Healthcare Claims / Medical Claims - Digitization Operations
- Experience managing large teams and multiple client accounts
- Strong exposure to transition, transformation, and client governance
Working Conditions:
- Flexibility to support business and client requirements
- Readiness to manage peak operational periods
- Ability to travel for client and governance meetings as required
