Manager

Location

Pune | India

Job description

System Responsibilities

Assist with the leading of the configuration of client s rules, benefits, members, and providers in concert with the Director

Oversee the submission and tracking of support tickets for processing system, and report bottlenecks

Ensure policies, procedures and formal delegations are in place to maintain effective coordination and control of configuration, provider network, and regulatory department activities

Ensure that service and product standards are in place and that programs and training are in place to assure consistent achievement of targets

Regularly evaluate policies and procedures to ensure consistent application and effective operation

Evaluate and ensure overall quality of service delivery process and illuminate vulnerabilities early for mitigation

Recommend alternative strategies to improve effectiveness of operations

Establish measures and processes by which to collect, monitor, evaluate, and report on key performance indicators

Ensure the information and data integrity of the processing systems

Continually increase the use of data as a basis for making business decisions

Assist in the exploration and evaluation of in-house or purchased technology solutions for current and future business needs.

Instill and reinforce an outstanding service culture for internal & external customers

Take prompt and decisive corrective action when necessary to ensure achievement of financial, operational, quality and service goals

Management support for business evolution and process improvement

Assist in the evaluation of department readiness and staff preparedness for business evolution and expansion

Assist in the facilitation of process improvement projects identified, prioritized and assigned across the organization

Participate in all phases of project management to make certain that the objectives are accomplished on time and within budget and that risks have been identified and properly mitigated

Facilitate workgroups to identify ways to increase quality and efficiency and business and operations processes

Assure effective communication as organizational changes are implemented

Talent Management

Collaborate with Director, HR, parent company and VP/SVP to attract, develop and retain talent

Provide direct reports with timely and constructive performance feedback

In accordance with company human resource policies and procedures, review, recommend or approve promotions and salary reviews

Advise the management team on client issues.

Ensure all direct reports are fully informed of operational objectives and input is obtained prior to significant operational changes

Conduct regular meetings with Director, direct reports and staff to communicate priorities and coordination of activities

Support company-wide performance planning, coaching, appraisal and discipline programs to ensure consistent, fair, and transparent implementation and compliance with company policies and procedures

Additional Functions:

Assist Director with team meeting agendas, recognitions, etc.

Communicate clearly and concisely, with sensitivity to the needs of others

Maintain courteous, helpful and professional behavior on the job; display a willingness and ability to be responsive in a warm and caring manner to all customer groups; consistently cooperates and supports organization in problem solving issues; ensure customer satisfaction; will support the success of the entire team; establish and maintains effective working relationships with co-workers

Follow all Policies and Procedures and HIPAA regulations

Maintain a safe working environment

Maintain the confidentiality of all company procedures, results and information about participants, clients, providers and employees

Assist with special projects as requested by the Director

Supervisory Responsibility: Responsible for overall leadership of the Provider Network Specialists, and for direct leadership of the Provider Network Supervisor/Manager, EDI Data Specialists and Configuration Analysts.

Travel: Periodic travel, 10-20%, depending on business needs.

Knowledge, Skills and Abilities:

Combination of at least 10 years of Medicare/Medicaid and Managed Long Term Care experience in leadership rol.

MBA or equivalent business experience preferred

Strong background in operations, financial management, IT and accounting

Strong people skills and experience supporting a Director

Outstanding, leadership, management and organizational skills

Capacity to oversee a complex operation, and the leadership skills to function as a mentor and coach and filter/illuminate items requiring Director s attention

Ability to budget and forecast demand, revenues and expenses and control costs./minimize overtime

Understand how to use data to drive & develop business plans and evaluate business trends to modify strategies and corrective actions

Ability to set and meet high standards of service to develop a work force that embraces a culture of quality and service

Ability to function effectively, exert influence and gain consensus at all organizational levels, in both direct, matrix and consultative organizational relationships, with internal stakeholders as well as external constituents

Personal integrity and exemplary ethical standards

Excellent time management skills and know how and when to impose deadlines and delegate tasks

A forward-thinking personality who can identify areas for improvement and take decisive and timely action to bring about the desired change

The ability to attract, train, manage and motivate a skilled team

Physical Demands & Requirements :

Communicate by way of the telephone with participants, customers, vendors and staff

Operate a computer and other office productivity machinery, such as a calculator, copy machine, fax machine and office printer

Remain stationary for extended periods of time

Visual acuity to perform activities such as identifying, inputting and analyzing data on a computer terminal and/or in hard copy

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