Operations Manager – Insurance Case Management at Vlbpo llc

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Full Time

Start Date

Immediate

Expiry Date

05 Jul, 26

Salary

0.0

Posted On

06 Apr, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Operations Management, Insurance Case Management, Team Leadership, Performance Management, SLA Management, KPI Monitoring, Workforce Planning, Capacity Planning, Client Management, Escalation Management, Data Analysis, HIPAA Compliance, Process Improvement, Claims Processing, Coaching, Reporting

Industry

Outsourcing and Offshoring Consulting

Description

Position Information Job Title: Operations Manager – Insurance Case Management Department: Operations Reports To: Head of Operations / Director of Operations Location: Remote Employment Type: Full-Time Job Summary The Operations Manager – Insurance Case Management is responsible for leading and overseeing high-volume insurance case management operations in a fast-paced BPO environment. This role ensures the efficient handling of case workflows, achievement of service level agreements (SLAs), and compliance with all regulatory and client requirements. The Operations Manager will lead Team Leads, Supervisors, and Case Managers while serving as the primary point of contact for client communication and escalations. This role requires a results-driven leader with strong analytical, operational, and client management skills who can independently manage the account and drive continuous improvement. Work Schedule Schedule: Monday to Friday (may require weekends based on operational needs) Time Zone: Must be able to work aligned with U.S. business hours Flexibility: Required during peak volumes, escalations, and client demands Essential Job Functions (Listed in order of importance with approximate % of time. Total equals 100%.) # Function % of Time 1 Operations Management & Oversight – Oversee daily insurance case management operations including authorizations, claims processing, and care coordination to ensure efficiency and accuracy. 25% 2 Team Leadership & Performance Management – Lead Team Leads, Supervisors, and Case Managers; conduct coaching, performance reviews, and corrective actions to drive results. 20% 3 KPI Monitoring & SLA Management – Monitor productivity, accuracy, QA scores, utilization, and turnaround times (TAT) to ensure all SLAs are consistently met. 15% 4 Workforce & Capacity Planning – Manage staffing levels, workflow distribution, and case prioritization to meet client demand and optimize performance. 10% 5 Client Management & Escalations – Act as the primary point of contact for clients; manage escalations, expectations, and maintain strong relationships. 10% 6 Reporting & Business Reviews – Prepare and present operational reports, insights, and lead Weekly/Monthly Business Reviews (WBR/MBR). 10% 7 Compliance & Risk Management – Ensure adherence to HIPAA regulations, data privacy standards, and internal compliance requirements. 5% 8 Process Improvement & Efficiency – Identify operational gaps and implement process improvements to enhance efficiency and service delivery. 5% Required Qualifications (Knowledge, Skills & Experience) Bachelor’s Degree in Business Administration, Management Studies, or a 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. Preferred Qualifications Experience managing claims processing or insurance-related teams. Experience supporting U.S.-based healthcare or insurance clients. Advanced proficiency in Excel and reporting tools. Experience in workforce management, capacity planning, and real-time operations. Work Conditions / Physical Demands / Travel Requirements This role operates in a fully remote, high-performance environment and requires: A quiet, professional workspace Reliable high-speed internet connection Laptop or desktop with additional monitor and a functioning camera Ability to manage multiple teams and attend frequent virtual meetings The role involves extended periods of computer use and requires strict adherence to confidentiality, data protection, and compliance standards. Important Notes This is a high-impact leadership role requiring full ownership of operational performance and client satisfaction. The Operations Manager is expected to balance performance, compliance, and team management in a fast-paced environment. Strong decision-making, accountability, and leadership presence are critical for success. Responsibilities may evolve based on client needs and operational growth. Disclaimer This job description outlines the general nature and level of work performed and is not an exhaustive list of duties. Responsibilities may be adjusted to meet business needs. © VL BPO | Confidential & Proprietary Template Location Remote Employment Type Full-Time Minimum Experience Experienced

Responsibilities

The Operations Manager oversees high-volume insurance case management operations, ensuring efficiency, accuracy, and adherence to service level agreements. They lead teams, manage client relationships, and drive continuous process improvements while maintaining strict compliance with regulatory standards.