AVP - Claims handling (US Healthcare)

As an accomplished AVP Claims Operations (US Healthcare), your role will involve leading and transforming large-scale claims operations to elevate service delivery and drive innovation across a major healthcare BPM setup. You will oversee multi-location delivery teams, partner with global stakeholders, lead automation and analytics-driven transformation, and manage a portfolio of USD 1020M. This high-impact leadership role reports into the senior operations leadership team. Key Responsibilities: - Lead end-to-end US Healthcare Claims Operations to industry-leading standards. - Manage large-scale back-office claims functions including PI, SIU, Rework, Enrollment, Coding, Product Build, etc. - Drive automation, RPA, analytics, and transformation initiatives. - Manage P&L, budgets, revenue optimization, cost control, and workforce planning. Client & Stakeholder Management: - Act as the primary operations leader for client engagement, reviews, and performance governance. - Present insights, solutions, and recommendations for business growth and value creation. People Leadership: - Lead a span of 800+ FTE across multiple locations. - Drive performance management, succession planning, training, and employee engagement. Governance & Compliance: - Ensure adherence to HIPAA, ISO, and internal audit/compliance requirements. - Own SLA delivery, quality metrics, audits, and performance scorecards. Ideal Candidate Profile: - 1820+ years of experience in Healthcare BPM with 1012+ years in US Healthcare Claims Operations. - Proven experience managing large delivery teams and multimillion-dollar portfolios. - Demonstrated expertise in transformation, automation, and service delivery excellence. - Strong communicator, influential leader, and solution-oriented thinker.,