Role Proficiency:

A manager should be able to manage all operations for a process / client depending upon the size of the engagement (typical span: 50-80 associates). meet SLAs while independently drive operational efficiency

Outcomes:

     Works closely with the Manager/Group Manager to achieve quantitative and qualitative SLAs and KPIs for the team.      Focuses on planning and execution to ensure quality improvement turnaround time and overall process efficiency.      Identifies process gaps and collaborates with the client to formulate solutions for the same.      Regularly interacts with the Quality team to ensure real time action in cases of quality defects.      Leads corrective and preventive action plans for various transactions and owns them.      Ensures that leads are informed on all process and business updates; and the relevant information is cascaded to associates in every team to ensure transparent communication.       Set clear team goals and transparent objectives on what the team is working towards to ensure clarity.

Measures of Outcomes:

     100% Adherence to quality standards process and SLA’s      Number of issues resolved and tasks completed      Number of non-compliance issues with respect to SOP      Zero/No Client Escalations      Percent of completion of all mandatory training requirements      Percent of QC and QA scores      RCA and Corrective Action Plans      Daily/weekly performance reporting      Number of high-quality RCA and QA output   Guides and mentors the junior associates.   Swift turnaround time for response and resolution   Update SOPs and job aids on a weekly basis   Delegate tasks and set deadlines for the team

Outputs Expected:

Operations:

Ensure team handles the work received and adheres to SLAs

Quality:

Responsible for creating quality plans and implementing quality management function

Communication:

Responsible for reporting and communicating with client and internal team members. Communicates with clients daily and provides status update
obtains feedback and acts immediately on any issues highlighted. Provides status update to the respective stakeholders and within the team Shares performance reports to the client at the end of every month on team output and productivity.

Process/efficiency Improvement:

Proactively identify opportunities to increase service levels and mitigate any issues in delivery within the function or across functions. Take accountability for overall productivity efforts within the function
including coordination of function specific tasks.

Training:

On time completion of all mandatory training requirements of organization and customer. Provide on floor training and one on one mentorship for new joiners. Complete certification of respective career paths.

Performance Management:

Update FAST Goals in NorthStar
track
report and seek continuous feedback from peers and manager. Set goals for team members and mentees and provide feedback.

Escalation:

Escalate problems to appropriate individuals/support team based on established guidelines and procedures.

Monitoring:

Monitors progress of requests for support and ensures users and other interested parties are kept informed.

Process Adherence:

Thorough understanding of organization and customer defined process. Consult with mentor when in doubt. Adherence to defined processes. Adhere to organization’ s policies and business conduct.

Manage knowledge:

Consume project related documents
share point
libraries and client universities

Issue Resolution:

Identifies
analyses and solves the incidents/transactions. Perform root cause analysis to find corrective and preventive actions after every major incident and escalations. Work closely with team members to solve customer problems. Understand agent's problems and weaknesses and address

Release:

Adhere to release management process

Team management:

Set expectations; manage performance of team and individuals. Provide regular feedback. Coach team towards operational excellence. Recognize high performing talents in the team and reward them.

Mentoring:

Guide new team members in understanding customer infrastructure and processes. Mentoring and providing guidance to the peers and junior associates. Assist new team members to understand the customer environment.

Management:

Able to make decisions on any matters relating to improving revenue generation and customer satisfaction with regards to call handling and call center processes.

Skill Examples:

     Customer Focus: Focus on providing a prompt and efficient service to customers; goes out of the way to ensure that individual customer needs are met.      Attention to detail to ensure metrics quality and production output and reporting is accurate      Team Work: Respect others and work well within the team.      Communication: Speak clearly and write in a clear and concise manner. Uses appropriate style and language for communication (Data)      Communication: Speaks in an accent neutral manner or with the accent required for the process with good vocabulary and grammar skills. Writes clearly (Voice)      Analysis and Decision Making: Makes judicious and fair decisions after examining all relevant information and making clear assumptions      Team Coaching and Leadership: Lead the team by example. Guide and support the team towards the achievement of goals.      Coaches and guides lead’s in managing outcomes and expectations well.      Manage and facilitate aspirations and skill development for team.   Proactive in avoiding or resolving conflicts.   Planning skills: Translate business objectives into functional activities. Set goals and processes and organize resources to ensure that the desired results are met.   Excellent communication and leadership skills.   Organizational and time management skills.   Assistant Manager - Operations Training Quality MIS Process Excellence   Leadership role with span of up to 60 FTE

Knowledge Examples:

     Familiar with Windows Operating Systems MS Office      Excellent English comprehension – reading writing and speaking      Domain knowledge based on process (healthcare banking investment F&A retail customer support etc)      Expertise with process knowledge and guidelines      Expertise in work allocation and intake functions      Expertise in MS Excel      Expertise with quality control processes including pare to analysis and root cause analysis      Typing speed with 15WPM and 80% accuracy Voice      Typing speed with 30WPM and 95% accuracy Data   Experience level – 9 to 12 years

Additional Comments:

Manager, Provider Credentialing About UST HealthProof At UST HealthProof, you will join a fast paced, growing company in our mission to reshape the future of health insurance through significantly reducing administrative costs and building better healthcare experiences for our health plans customers and their members. By creating a modern, cloud based, Best-In-Class core administration ecosystem, we have made healthcare more affordable and helped our health plans operate more efficiently. Through member and provider touchpoints with less friction, we have created real impact for members. UST HealthProof is run by leaders with strong health plan and technology backgrounds who have start-up mindsets and an environment of support where individual growth is nurtured. You will be supporting our proven core admin solutions and business process-as-a-service (BPaaS) operations to provide transparency, improve operational efficiency, and break down operational barriers to scale and drive strategic growth. UST HealthProof is looking for Provider Credentialing Manager, reporting to the Director of Business Operations. The Credentialing Manager is responsible for a team of up to 12-15 credentialing specialists, extensive interaction with client organization, and multiple stakeholders. The Credentialing Manager is accountable for delivering a high-quality credentialing operation, exceeding all service level agreements and KPIs, driving operational excellence, and building competencies for delivery. As a Provider Credentialing Manager at UST HealthProof, this is your opportunity to • Be responsible for directly managing a staff of up to 12 – 15 associates • Manage the workflow for staff that process provider credentialing and recredentialing applications for medical providers • Implement policies & procedures to ensure applications are properly verified and accurately uploaded into a credentialing database system • Ensure credentialing applications are tracked and monitored for adherence to timelines and quality standards • Analyze and prepares reports on results of the Credentialing Verification Organization in the application status • Conduct training sessions for staff members on new policies or procedures, as well as ongoing training to ensure that associates are familiar with protocols • Provide coaching and upskilling to staff members depending on quality results • Make recommendations on improvements to the credentialing and recredentialing policies and procedures, based on experiences and/or evolving regulatory requirements • Identify training and development needs You bring: • 7+ years Credentialing experience in progressively more responsible positions • Minimum of 3 years of Credentialing management experience • Strong understanding of credentialing databases/systems, Santech preferred • Associate degree in related health care field, or commensurate experience • Ability to effectively lead a credentialing team • Excellent communication skills (verbal and written) • Willingness to learn new skills • Team collaborator • Strong work ethic For this role, we value: • The ability to adapt quickly to a fast-paced environment • A self-starter and quick learner • Team player with an ability to collaborate • Ability to coach the team to reach their full potential