About this role
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)
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
2. 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
3. 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
4. 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
5. 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
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