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Legato
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Benefits & Claims - Lead

Benefits & Claims - Lead

Legato

8 - 10 years

10 - 12 Lacs

Hyderabad

Posted:2 weeks ago| Platform:

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Skills Required

SAN Claims Project management Focus Performance appraisal Succession planning Genetics Medical insurance US healthcare Capacity planning

Work Mode

Work from Office

Job Type

Full Time

Job Description

. 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.

ABOUT CARELON

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

JOB POSITION

Carelon Global Solutions India Seeking a Lead EBA.
Managing the day-to-day operations.
Capacity planning and assess capacity shortages and requirement for overtime.
Ensures individuals and the team meet their performance objectives.
Act as a liaison with the client for any process updates, additional scope, training.

JOB RESPONSIBILITY

Responsible for managing the team of ~ 18 to 25 resources.
Responsible for meeting daily, weekly, monthly internal metrics (AHT, Utilization, Internal & External Quality, TAT, Productivity).
Responsible for ensuring SOPs and training materials are up to date.
Review capacity requirements on an ongoing basis and initiate hiring, redeployment requests as required.
Additional focus required for Open Enrollment capacity planning.
Strong operational management skills.
Conduct timely performance appraisal for associates.
Excellent knowledge on Excel & PowerPoint.
Succession planning in placed for all critical resources.
Assists in Function level reporting.
Inter-team collaboration with other leaders providing assistance and seeking support wherever required.
Active participation on Process improvements & Project Management.
Flexible to work in US shifts.
Timely management of bottom quartiles performers
Partner connect.
People Engagement

QUALIFICATION

Graduation/ Post graduation.

EXPERIENCE

Minimum 8-10 years Experience in US Health Care. Experience in Benefit configuration, testing & Auto adjudication & Claims Testing is an added advantage.
Minimum experience. Minimum 8-10 years Experience in US Health Care
Preferred experience. Preferred with basic US Healthcare knowledge.
Highlight Basic Minimum Experience. This section focuses on attributes (not tasks or actions) a candidate must possess at the time of hire to enter the position. If a particular experience is a nice-to-have but not required, make it clear in this section. Includes the following sub-headings:

SKILLS AND COMPETENCIES

Strong communication skills, Ability to perform individually in a competitive environment, Superior ability to manage customer relationships.
Responsible for meeting daily, weekly, monthly internal metrics (AHT, Utilization, Internal & External Quality, TAT, Productivity, Capacity planning)
Excellent knowledge on Excel & PowerPoint
Inclusive mindset and collaborating with diverse stakeholders.

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

Reasonable Accommodation

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*

Job Type:

Full time

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Benefits & Claims - Lead