Healthcare Operations Supervisor | Provider Services

Job description

Healthcare Operations Supervisor | Provider Services Work Set-up: Onsite - eligible to WFH after training based on performance and business requirements Location: Valero , Makati City Schedule: Graveyard | Shifting Hours Job Summary The Healthcare Operations Supervisor - Provider Services plays a critical leadership role in driving operational excellence across multiple healthcare support teams. This position is responsible for ensuring Team Leaders and their teams consistently achieve performance, quality, compliance, productivity, service-level, and provider experience goals while supporting claims, eligibility, payments, appeals, EOBs, and other provider-related inquiries. The Supervisor serves as a key escalation point, develops frontline leaders, manages operational risks, and partners with cross-functional teams to deliver outstanding client and business results. Key Responsibilities Operations Leadership & Performance Management Oversee the daily operations and performance of multiple Provider Services teams across various support channels. Lead, coach, and hold Team Leaders accountable for achieving operational goals and performance expectations. Monitor key metrics including productivity, quality, attendance, schedule adherence, service levels, turnaround times, and provider experience. Analyze operational reports, dashboards, and performance trends to identify risks, drive improvements, and implement corrective actions. Partner with Workforce Management and other cross-functional teams to ensure adequate staffing, operational readiness, and consistent execution of business priorities. KPI, Reporting & Business Performance Partner with Quality and Team Leaders to drive consistent quality performance, compliance, and operational excellence across assigned teams. Monitor QA results, error trends, documentation accuracy, and compliance findings to identify risks and improvement opportunities. Lead root-cause analysis and collaborate with Quality and Training teams to resolve recurring quality, process, system, or knowledge gaps. Promote a Zero Error Mindset by ensuring adherence to approved workflows, documentation standards, escalation procedures, and regulatory requirements while promptly escalating critical compliance or operational concerns. Quality, Compliance & Zero Error Mindset Partner with Quality and Team Leaders to maintain consistent quality performance across assigned teams. . Ensure Team Leaders appropriately address QA findings through coaching, corrective actions, refresher training, and performance management. Partner with QA and Training to identify process, knowledge, system, or behavioral issues contributing to performance defects. Reinforce a Zero Error Mindset across all assigned teams focused on preventing avoidable errors and protecting provider and member experience. Workforce & Capacity Management Partner with Workforce Management to monitor staffing levels, schedules, attendance, adherence, queue volumes, service levels, and operational capacity. Support workforce planning and operational decisions related to volume fluctuations, staffing changes, training classes, nesting, leaves, and business requirements. Ensure Team Leaders effectively manage attendance, schedule adherence, breaks, and real-time operational coverage. Support operational readiness for new programs, process changes, volume increases, and client transitions. Training, Nesting & Operational Readiness Partner with Training, QA, and Team Leaders to ensure successful onboarding, certification, nesting, and production readiness of new hires. Monitor new-hire performance, productivity, quality, attendance, adherence, and overall progression during training and the first 90 days. Ensure teams stay updated on client requirements, process enhancements, system updates, policies, and performance expectations. Support the implementation of new processes, systems, workflows, and operational changes to maintain business readiness and operational excellence. Process Improvement & Operational Excellence Identify opportunities to improve productivity, quality, service levels, provider experience, workflow efficiency, and operational consistency. Use performance data, QA findings, employee feedback, provider concerns, and operational trends to identify root causes and improvement opportunities. Lead or participate in process-improvement initiatives and operational projects. Promote standardization and consistency across Team Leaders and assigned teams. Identify recurring operational issues and recommend appropriate process, system, training, staffing, or workflow solutions. Compliance, Privacy & Security Ensure assigned teams comply with HIPAA requirements and all applicable privacy, security, confidentiality, client, and Imagenet standards. Ensure Team Leaders reinforce required caller/provider verification practices before protected information is accessed, discussed, or disclosed. Ensure assigned teams complete required compliance training, certifications, acknowledgments, and other mandatory requirements within established timelines. Promote a culture of accountability regarding confidentiality, security, compliance, and appropriate handling of protected information. Qualifications High school diploma or equivalent required; college degree or relevant post-secondary education is preferred. At least 5 years of experience in a healthcare contact center, provider services, claims support, or comparable healthcare operations environment. At least 2 to 3 years of experience in a Team Lead, Supervisor, or comparable people-management role. Experience managing multiple teams, Team Leaders, or a large contact-center workforce is strongly preferred. Working knowledge of healthcare claims, EOBs, appeals, eligibility, benefits, payment processes, provider-service workflows, and contact-center operations. Demonstrated ability to manage operational performance through KPIs, dashboards, reporting, root-cause analysis, and action planning. Proficiency with Microsoft Office and online systems; ability to learn and navigate multiple healthcare, client, reporting, workforce, QA, and performance-management systems. Experience with , AWS Connect, workforce tools, QA platforms, performance dashboards, and reporting systems is highly preferred. Ability to work flexible schedules, including nights, weekends, and holidays, based on client coverage and operational requirements. Performance Accountability Healthcare Operations Supervisors are accountable for the overall performance, quality, compliance, and development of their assigned teams. They are expected to drive KPI achievement, lead Team Leaders effectively, identify operational risks, and implement timely corrective actions. Remote or hybrid work eligibility is based on sustained leadership effectiveness, operational results, compliance, responsiveness, and business needs. Failure to meet performance or compliance expectations may result in coaching, performance management, or a return to onsite work in accordance with company policy. Additional Benefits: Comprehensive HMO Coverage - Medical & Dental HMO coverage on Day 1 plus 1 dependent About Imagenet Imagenet is a technology-forward healthcare operations partner with more than 25 years of experience helping healthcare payers manage critical administrative and operational processes. Founded in 2000 and headquartered in Tampa, Florida, Imagenet supports 150+ health plans through its payer clients. Our teams help improve efficiency, accuracy, visibility, and service across complex healthcare operations, including digital mailroom, claims adjudication, contact center, member communications, and related administrative functions. By combining experienced operational teams, proven processes, and purpose-built workflow technology, Imagenet helps payers keep essential processes moving for the members, providers, and communities they serve. Imagenet operates 10 secure facilities across the U.S. and one secure facility in Manila, Philippines. Joining Imagenet means contributing to work that supports the healthcare operations members and providers rely on every day.