Manager

Experience:

• Experience in US Healthcare / Payment Integrity / Payment Services preferred
• 2 – 4+ years of experience in program management / PMO / operations leadership role
• Experience managing audit lifecycle, claims operations, or PI functions
• Strong experience in client-facing roles and stakeholder management
• Experience in digital transformation / automation initiatives (Preferred)

Qualifications

Qualification:

• Bachelor’s degree in healthcare / Life Sciences / Business Administration
• MBA from a IIT / IIM or reputed Business management school
• Certifications: PMP / Lean Six Sigma / Agile

Communication Skill:

• Strong written (documentation) and oral communication skills

Working Hours:

• 40 hours per week as Full-time employee
• Shift time: 10:00 AM IST - 7:00 PM IST
• Weekends Off

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home, must be broadband

• Must understand and adhere with telecommuter policy.

Key Competencies

• Strategic Thinking & Program Governance
• Healthcare Operations Expertise
• Payment Integrity Knowledge (Claims / Coding / Audit)
• Data Analytics & Reporting
• Stakeholder & Client Management
• Process Improvement & Automation
• Risk & Compliance Management
• Leadership & Team Management

Responsibilities

\1.PMO Governance & Program Management

• Establish and enforce PMO frameworks, governance models, and operational standards
• Manage end-to-end lifecycle of programs/projects: planning, execution, tracking, and closure
• Ensure adherence to project timelines, SLA commitments, and delivery metrics
• Maintain program documentation, playbooks, SOPs, and reporting dashboards
• Drive portfolio visibility and track program performance across stakeholders

Operations Management & Delivery Excellence

• Oversee day-to-day operations of Payment Integrity / Payment Services workflows
• Drive operational efficiency, productivity, and quality improvements
• Ensure compliance with HIPAA, CMS, payer guidelines, and internal policies
• Monitor KPIs such as quality, productivity, cost savings, recovery, and turnaround time
• Identify process gaps and lead continuous improvement initiatives

Stakeholder & Client Management

• Act as a key interface between clients, operations, and leadership teams
• Present performance dashboards, insights, and improvement plans to stakeholders
• Coordinate with cross-functional teams (Analytics, Compliance, Finance, IT, Training)
• Manage escalations and ensure timely resolution

Analytics, Reporting & Decision Support

• Drive data-driven decision-making using dashboards and trend analysis
• Analyze operational and financial data to identify risks and improvement opportunities
• Prepare executive reports and business reviews
• Support leadership with strategic insights and recommendations

Team Leadership & Capability Building

• Lead and mentor PMO / operations teams
• Drive accountability for KPIs, SLAs, and delivery milestones
• Support workforce planning, training, and performance management