Operations Manager

Role Overview The Operations Manager will lead day-to-day delivery for a healthcare BPO account, managing a team of supervisors and frontline associates who handle clinical and non‑clinical processes for a global healthcare client. The role is accountable for operational performance, client satisfaction, people management, and compliance with all healthcare regulations and information security requirements. Key Responsibilities Operational Management: Own end‑to‑end delivery for assigned processes such as claims, prior authorization, utilization review, case management, member or provider support, or medical records. Achieve and sustain contractual SLAs and KPIs (AHT, productivity, quality, TAT), track daily performance through dashboards and reports, and drive action plans with Team Leaders. Manage staffing, schedules, and skilling in partnership with WFM to ensure right capacity and coverage. Ensure timely resolution of escalations from clients and internal stakeholders. Lead, coach, and develop a team of Team Leaders / Supervisors and frontline associates, driving engagement, motivation, and a high‑performance culture through regular 1x1s, huddles, and team connects. Own attrition, absenteeism, and tenure improvement for the account and identify skill gaps, partnering with Training / Quality to run upskilling, cross‑skilling, and refresher initiatives. Support fair and timely performance appraisals, rewards, and corrective actions when required. Client and Stakeholder Management: Act as the primary operational contact for the client’s operations leaders, participate in governance calls, business reviews, and performance deep dives, and translate client feedback into clear action plans with timelines and owners. Partner with internal stakeholders (HR, WFM, Training, Quality, IT, Compliance, Finance) to support account needs. Quality, Compliance, and Risk Management: Ensure strict adherence to healthcare regulations and standards (e.g. HIPAA), drive a strong quality culture using audits, RCA, CAPA, and continuous coaching, and ensure all staff complete mandatory compliance, information security, and process trainings on time. Proactively identify operational risks and implement preventive controls. Continuous Improvement and Transformation: Use data to identify trends, gaps, and opportunities to improve quality, efficiency, and customer experience, lead process improvement projects using Lean or Six Sigma concepts, and support automation, analytics, and digital initiatives that enhance performance and reduce cost to serve. Qualifications Bachelor’s degree in Nursing, Healthcare, Life Sciences, Business, or related field required. Master’s degree or healthcare certification (e.g. RN, USRN, CPC, CPHQ) is an advantage. Experience 7+ years total experience in BPO / shared services, with at least 3+ years in a strong background in healthcare processes such as payer, provider, PBM, utilization management, case management, or health insurance operations. Hands‑on experience managing a medium to large team (80+ FTE preferred) through Team Leaders or Supervisors. Proven track record of meeting SLAs, improving KPIs, and managing client relationships in a healthcare or insurance account. Skills and Competencies Technical and Domain: Solid understanding of US healthcare ecosystem (payer, provider, plans), strong grasp of metrics such as productivity, quality scores, AHT, FCR, TAT, occupancy, and utilization, comfortable with Excel and reporting tools for data analysis and performance management, working knowledge of quality frameworks and basic Lean or Six Sigma concepts. Leadership and Behavioral: Strong people leadership, coaching, and conflict management skills, excellent communication and presentation skills in English, client facing and comfortable handling escalations and difficult conversations, high sense of ownership, urgency, and accountability, ability to work in a fast‑paced, 24x7 global delivery environment. Key Performance Indicators SLA and KPI achievement for the line of business. CSAT / NPS and client feedback scores. Attrition and absenteeism within defined thresholds. Quality scores and audit findings. Aging, backlog, and turnaround time. Compliance adherence and zero tolerance incidents. Seniority Level Mid‑Senior level Employment Type Full‑time Job Function Customer Service Industries: IT Services and IT Consulting #J-18808-Ljbffr