Operations Manager – Insurance Case Management
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Job Description
Operations Manager overseeing high-volume insurance case management operations remotely. Driving efficiency, compliance, and team performance in a fast-paced BPO environment.
Responsibilities:
- Oversee daily insurance case management operations including authorizations, claims processing, and care coordination to ensure efficiency and accuracy.
- Lead Team Leads, Supervisors, and Case Managers; conduct coaching, performance reviews, and corrective actions to drive results.
- Monitor productivity, accuracy, QA scores, utilization, and turnaround times to ensure all SLAs are consistently met.
- Manage staffing levels, workflow distribution, and case prioritization to meet client demand and optimize performance.
- Act as the primary point of contact for clients; manage escalations, expectations, and maintain strong relationships.
- Prepare and present operational reports, insights, and lead Weekly/Monthly Business Reviews.
- Ensure adherence to HIPAA regulations, data privacy standards, and internal compliance requirements.
- Identify operational gaps and implement process improvements to enhance efficiency and service delivery.
Requirements:
- Bachelor’s Degree in Business Administration, Management Studies, or related field.
- Minimum 5+ years of experience in a BPO or call center environment, with leadership experience managing operations teams.
- Proven experience managing high-volume operations and multiple teams.
- Strong understanding of insurance case management, claims processing, or healthcare operations.
- Solid knowledge of HIPAA compliance and data privacy regulations.
- Strong leadership, coaching, and team development skills.
- Excellent communication skills with client-facing experience.
- Strong analytical and reporting skills with the ability to interpret data and drive decisions.
- Ability to take full ownership of an account and operate independently.
Benefits:
- Professional workspace
- Reliable high-speed internet connection
- Opportunity to manage multiple teams
- Flexibility during peak volumes and client demands
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