6 дней назад
Team Manager (Clinical Claims)
Вакансия из Hirify Global, списка международных tech-компанийДля мэтча и отклика нужен Plus
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
Текст:
TL;DR
Team Manager (Clinical Claims) (Healthcare Operations): Leading USRN clinical claims teams in Accident & Occupational operations with an accent on operational performance, quality, compliance, and employee development. Focus on coaching clinical claims specialists, improving claims accuracy and turnaround times, managing HIPAA requirements, and driving process improvement.
Location: Taguig, Philippines
Company
provides AI, automation, cloud engineering, advanced analytics, and business process services for global brands.
What you will do
- Lead the daily operations of USRN Clinical Claims Associates and Specialists supporting Accident & Occupational claims.
- Monitor productivity, quality, accuracy, compliance, service levels, and turnaround-time targets.
- Coach employees, conduct performance reviews, support career development, and manage attendance and engagement.
- Provide clinical guidance and ensure accurate claims processing, documentation, and adjudication.
- Support client business reviews, calibration sessions, stakeholder updates, and operational presentations.
- Lead workflow improvements, corrective actions, change management, and best-practice implementation.
Requirements
- Active and unrestricted US Registered Nurse (USRN) license required.
- Bachelor’s Degree in Nursing (BSN) or an equivalent nursing qualification.
- 3–5 years of clinical nursing experience in a hospital, healthcare, insurance, disability claims, utilization review, case management, or related setting.
- At least 2 years of people management experience leading healthcare operations, clinical teams, healthcare BPO accounts, or claims operations.
- Strong knowledge of medical terminology, clinical documentation, healthcare processes, HIPAA, and compliance requirements.
- Excellent written and verbal English communication, analytical, coaching, and stakeholder management skills.
Nice to have
- Experience in disability claims management, clinical claims review, utilization management, case management, health insurance operations, or healthcare BPO operations.
- Experience managing US healthcare or insurance accounts.
- Lean Six Sigma, quality, or process improvement certification.
- Experience with client-facing operational reviews and presentations.
Culture & Benefits
- Full-time employment focused on operational excellence and measurable client outcomes.
- Performance culture centered on accountability, continuous improvement, and employee development.
- Collaboration with HR and Operations leadership on employee relations and retention.
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