AVP - Claims handling (US Healthcare)
Selections HR Services Private Limitedbhubaneswar, orissa, in21 hours ago
Job descriptionAct as the primary operations leader for client engagement, reviews, and performance governance. Present insights, solutions, and recommendations for business growth and value creation. Lead a span of 800+ FTE across multiple locations. Drive performance management, succession planning, training, and employee engagement. Ensure adherence to HIPAA, ISO, and internal audit / compliance requirements. Own SLA delivery, quality metrics, audits, and performance scorecards. 18–20+ years of experience in Healthcare BPM with 10–12+ years in US Healthcare Claims Operations . Proven experience managing large delivery teams and multimillion-dollar portfolios. Strong domain knowledge of the claims lifecycle and payer operations. Demonstrated expertise in transformation, automation, and service delivery excellence. Strong communicator, influential leader, and solution-oriented thinker.
About the Role
We are hiring an accomplished AVP – Claims Operations (US Healthcare) to lead and transform large-scale claims operations, elevate service delivery, and drive innovation across a major healthcare BPM setup.
The role oversees multi-location delivery teams, partners with global stakeholders, leads automation and analytics-driven transformation, and manages a portfolio of USD 10–20M. This is a high-impact leadership role reporting into the senior operations leadership team.
Key Responsibilities
Strategic & Operational Leadership
- Lead end-to-end US Healthcare Claims Operations to industry-leading standards.
- Manage large-scale back-office claims functions including PI, SIU, Rework, Enrollment, Coding, Product Build, etc.
- Drive automation, RPA, analytics, and transformation initiatives.
- Manage P&L, budgets, revenue optimization, cost control, and workforce planning.
Client & Stakeholder Management
People Leadership
Governance & Compliance
Ideal Candidate Profile
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