Hiring for AVP Operations - Claims Management in Delhi/NCR, for Exp. 13 - 23 yrs at Naukri Premium - Employer Services.

  • Esteemed client of Orion TrueTech Services India
  • Delhi, New Delhi, India
  • May 17, 2018
Full time Pharma, Healthcare & Biotechnology Jobs

Job Description

Job Description:Duties and Responsibilities Leadership &amp amp amp Development Implement leadership development opportunities and create and execute on opportunities to improve employee and leadership engagement Develop and empower management staff to deliver departmental goals and objectives Lead large claims organization with over 500 FTE while providing support for assigned clients Develops &amp amp amp executes strategic claims initiatives which have substantial impact on the success of claims handling, enhance the customer experience &amp amp amp successfully meet the annual business operating priorities Provides subject matter expertise to team members and internal/external stakeholders on complex assignments/projects Provides training and development opportunities, including stretch assignments, for team members and gives honest and open feedback to aid in the development of talent Directs, establishes, and implements priorities, performance goals and objectives to ensure departmental results Provides subject matter expertise &amp amp amp complex technical guidance to claim team members on claims adjudication Customer Focus Develops &amp amp amp maintains close customer ties, articulates customer needs, keeps priorities in focus with the desires and expectations of the customer Contribute to developing strategies which have substantial impact on the success of claims handling &amp amp amp enhance the customer experience. Collaboration and partnership with other leadership to create and maintain a positive and integrated customer experience from initial claims intake through ongoing adjudication and resolution. Directs and evaluates departmental performance and takes appropriate action to meet and/or exceed performance standards. Monitors &amp amp amp assesses trends in claims, identifies opportunities, and implements industry leading best practices &amp amp amp strategies to enhance the customer experience &amp amp amp improve claim management effectiveness. Organizational Effectiveness Collaborates with internal &amp amp amp external stakeholders to establish credibility, trust and ensure effective service delivery of claims organization. Builds organizational capability Provides strategic leadership and direction to continually improve the capability and results in partnership with internal stakeholders. Maintains knowledge on current and emerging developments/trends, assesses the impact, and collaborates with senior management to incorporate new trends and developments in current and future strategies. Directs and enhances organizational initiatives by positively influencing and supporting change management and/or departmental/enterprise initiatives. Operations Develops &amp amp amp implements policy and guidelines in compliance with objectives &amp amp amp Healthcare laws &amp amp amp regulations. Manage current and future implementations and system enhancements by collaborating with various business areas and process owners. Collaborate with clients and onshore team to implement enhancements both onsite and offsite. Collaborate with all cross-functional team members/system owners to accomplish required tasks and provide project updates. Ensures all Claims, eligible or ineligible for payment conform to quality, production standards &amp amp amp specifications. Develops, maintains &amp amp amp analyzes appropriate metrics &amp amp amp control mechanisms for claims including using data &amp amp amp analysis to improve business results by targeting opportunities &amp amp amp process improvements within claims. Ensures claims processing is consistent with applicable policies, procedures &amp amp amp department guidelines for Disability Claims Directs the processing and administration of all aspects of claims to ensuring accurate &amp amp amp timely claim management. Identifies and directs strategic process improvements that significantly reduce workloads or improve quality across the team. Anticipates &amp amp amp provides strategies/solutions to complex claims problems or trends. Education and Experience Bachelor' s degree from a reputed institution 10+ years of experience in US Healthcare Claims that directly aligns with the specific responsibilities for this position 5+ years of managerial, supervisory, and/or demonstrated leadership experience including influencing senior management/critical stakeholders experience