AVP Clinical Operations | US Healthcare

Hello,

Please share your updated resume at gemini.goyal@cotiviti.com if interested. Thank you

Summary :

We are currently seeking an AVP – Clinical Operations with excellent operational acumen and people management skills. AVP will be required to communicate with the client (externally) and various departments of Cotiviti (internally) to ensure a high quality of service. Achieving and surpassing service level benchmarks would be a key responsibility. A good understanding of the processes and managing them through frequently occurring changes will be vital for meeting SLAs. Managing resources, their issues and their career planning is required for the team continuously improve their performance which would result in client delight. Handle large number of teams with the support of managers, AMs and team leads.

Principal Duties / Responsibilities :

Program Management :

Ensure that the SLAs are met consistently

Identify initiatives and have the Team Leads work on them for improvement of key metrics

Support QIPs to improve efficiency and quality

Present SLAs and associated metrics to reporting manager as well as to the client

Handle various teams in different phases (i.e. implementation, stabilization, BAU)

Client Management :

Timely, complete and articulate communication with the client

Highlight issues and propose solutions even before

Escalate to the reporting manager and client engagement team as required

People Management :

Managing people related issues that are escalated by TLs

Coordinate with department heads for resolution

Career planning of direct reports and guiding TLs in doing so for their teams

Realistic and measurable goal setting

Monitor & control attrition and shrinkage

Create back up for each support role

Initiative :

Either come up with or identify initiatives that will result in measurable improvement

Constantly monitor these initiatives and guide the team in making it a success

Change Management :

Manage various types of changes :

Change in process

Expansion due to volume increase

New implementations

Organizational changes e.g. Mergers, accreditation, etc

Attributes and behavior :

Should not just be a fast learner but also an effective mentor

Have sound knowledge of the program and know where & how to access the finer details

Willingness to work under pressure and stay motivated when there is less to be done

Has credibility with peers and seniors

Have a positive influence on others

Self-motivated – driven to achieve results

Have a levelheaded mindset which makes one think that ‘no problem is so big that it cannot be solved and none are too small to be attended to’

Passionate about delighting the customer time and again

Good knowledge of general policies and procedures in industry

Ability to adapt to policies and procedures specific to Cotiviti

Maturity and leadership to manage senior support staff such as managers.

Exhibit behavior consistent with Cotiviti Values

Customer Driven

Collaborative

Accountable

Open

Relevant Experience and educational requirements :

Medical qualification- MBBS, BHMS, BAMS,, preferably in clinical sciences preferred

CPC / CIC / CCS certification

Additional relevant certifications would be an added advantage

15 years of experience in BPO / KPO industry

3+ years of experience as Senior Manager / Director Operations

Experience managing Managers or similar levels

Experience in US healthcare health plan operations (pre-adjudication, post adjudication or adjudication) preferred

Implementations / transitions experience preferred

Regards

Talent Acquisition Team COTIVITI