Team Lead Claims
Team Lead -Quality
Associate Manager/ Sr Manager BPM
ABOUT ELEVANCE HEALTH
Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler. It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states.
A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux , President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list.
Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system.
Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers.
Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective, and efficient.
OUR MISSION & VALUES
Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More.
Our Values: Leadership | Community | Integrity | Agility | Diversity
Carelon Global Solutions India is seeking a highly creative and meticulous Team Lead, who will be responsible for all business delivery & performance as per set SLA parameters. The incumbent will report to Associate Manager – Business operations and must understand the business delivery, maintain & publish metrics with multiple stakeholders; brief and deliver all in-house process delivery & requirements, apart from coordinating with onshore partners as and when required.
Team Lead – Quality (Business Operations) will be responsible for the following:
- Excellent communication skills
- Leadership ability
- Outstanding organizational skills
- Managing a team of 20-25 QAs
- Conducting daily huddles, knowledge management, cross training as required
- Drive team to achieve process Service Level Agreements / metrics on productivity and quality within the established timelines
- Share status reports with business leaders for review on a periodic basis.
- Ensure adherence to engagement plans for team members
- Manage attrition and absenteeism and maintain EWS (Early warning system) for the team
- Identify opportunity areas for improvement in quality & productivity
- Conduct performance appraisals for team members
- Follow the performance management grid & take immediate steps for any variance
- Ensure performance report (presentation/visual boards) is shared with team on a regular basis
- Ensure successful execution of the plans & strategies as laid out by management time to time.
- Engage with other processes to understand and implement best practices.
- Perform RCA & come up with CAPA
- Total Quality Management
Good to Have
- Prior Team Lead/SME designation and Team handling experience will be an added advantage
- MBA degree and PG would be added advantage
- Lean/Six sigma experience
- Project Management experience
- Proven work experience as Team Lead -Quality or similar role
- Overall 7+ years of Health Care experience and at least 2 years in leadership role
- Healthcare / Claims Experience will be added advantage
SKILLS AND COMPETENCIES
- Thorough understanding of day-to-day claims operation challenges and work around
- Detailed understanding of Claims (Processing level) and Hospital processing guidelines
- Demonstrate strong organizational skills, attention to detail, good verbal, and written communication skills
- Process improvement experience
- Flexible to work in any shifts/Work from office
THE CARELON PROMISE
Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates.
It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate.
This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging.
LIFE @ CARELON
- Extensive focus on learning and development
- An inspiring culture built on innovation, creativity, and freedom
- Holistic well-being
- Comprehensive range of rewards and recognitions
- Competitive health and medical insurance coverage
- Best-in-class amenities and workspaces
- Policies designed with associates at the center
EQUAL OPPORTUNITY EMPLOYER
Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.
Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work.
If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form.
Disclaimer: Offered designation titles differ*
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