Group Manager Healthcare Operations

Role Overview Lead end-to-end offshore revenue cycle management delivery for US healthcare clients with responsibility for managing large teams of 300 to 1500 plus full-time employees. Drive operational excellence across front-end, mid-cycle, and back-end RCM functions while ensuring compliance with US healthcare regulations and payer requirements. Oversee financial performance, implement automation and process improvements, and develop high-performing offshore delivery centers. Key Responsibilities - Oversee complete revenue cycle management operations delivered from India including insurance eligibility verification, medical coding with ICD-10-CM CPT HCPCS standards, claims submission, payment posting, and denial management - Act as primary India delivery leader for US healthcare clients conducting regular business reviews, managing SLAs and KPIs, and ensuring contractual performance metrics are met - Drive financial and operational performance by optimizing key RCM metrics including days in accounts receivable, net collection rate, first pass resolution rate, denial rate and cost per transaction - Lead large offshore delivery teams implementing Lean and Six Sigma methodologies, driving automation through RPA and AI-assisted tools, and establishing second-line leadership development programs Required Qualifications - Bachelor's degree in healthcare, business, finance, or related field with 15 to 20 plus years of US healthcare revenue cycle management experience - Minimum 5 to 10 years of experience leading large offshore teams with demonstrated expertise in multi-specialty RCM operations - Strong understanding of US healthcare regulatory requirements including HIPAA HITECH CMS compliance PCI standards and US billing and coding regulations Why Join Us Join IBM's healthcare operations team and make a significant impact on critical revenue cycle processes for major US healthcare organizations. This role offers the opportunity to lead large-scale transformation initiatives, develop emerging leaders, and drive financial performance while working with cutting-edge automation technologies. NA

- 15 to 20 plus years US healthcare revenue cycle management experience - 5 to 10 plus years leading large offshore teams - Bachelor's degree in healthcare business finance or related field - Expertise in medical coding ICD-10-CM CPT HCPCS - Strong knowledge of US healthcare regulatory compliance HIPAA HITECH CMS - Experience with Lean and Six Sigma methodologies - Proficiency in revenue cycle metrics and financial KPI management - Leadership skills for managing 300 to 1500 plus full-time employees - Client engagement and stakeholder management capabilities - Understanding of multi-specialty RCM operations - PCI compliance and internal audit knowledge

- Opportunity to lead transformation initiatives in healthcare operations - Development of second-line leadership and talent succession planning - Exposure to automation and AI-assisted technology implementation - Global stakeholder management experience - Professional growth in healthcare revenue cycle management