Supv Claims Operations

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.

The Supervisor of Operations – Offshore Vendor Oversight is responsible for the day-to-day operational oversight, performance management, and quality assurance of an offshore claims processing vendor supporting Independence’s Claims Processing operations. This role ensures that all vendor-managed functions are completed promptly, accurately, professionally, and in compliance with contractual, regulatory, and departmental requirements.

The Supervisor serves as the primary operational liaison between Independence and the offshore vendors, providing direction, guidance, issue escalation, and continuous improvement oversight to ensure service levels and customer experience expectations are consistently met.

Responsibilities

• Provides operational oversight and governance of offshore vendor claims processing activities.
• Ensures vendor compliance with contractual service level agreements (SLAs), key performance indicators (KPIs), quality standards, and regulatory requirements.
• Monitors daily, weekly, and monthly vendor performance metrics including productivity, accuracy, turnaround time, and quality results.
• Evaluates operational effectiveness and efficiency of vendor-managed workflows and partners with the vendor to reallocate resources or adjust processes as needed.
• Serves as the primary point of contact for operational issues, escalations, and resolution of vendor-related concerns.
• Collaborates with internal stakeholders (Claims Operations, Quality, Compliance, IT, Finance, and Vendor Management) to coordinate vendor activities and resolve issues.
• Communicates, interprets, and enforces corporate and departmental policies, procedures, and process changes with the offshore vendor.
• Leads root cause analysis for errors, defects, or service failures and ensures corrective action plans are implemented and sustained.
• Supports implementation of new initiatives, system enhancements, and process changes involving the offshore vendor.
• Reviews and validates vendor training plans to ensure staff are properly trained on claims processing, systems, and Independence requirements.
• Provides ongoing feedback and coaching to vendor leadership to drive performance improvement and service excellence.
• Ensures all inquiries, follow-ups, and escalations handled by the vendor are resolved in a professional, accurate, prompt, and courteous manner.
• Compiles, analyzes, and prepares operational reports related to vendor performance, trends, risks, and improvement opportunities.
• Maintains department standards to ensure an optimal customer and provider experience.
• Ensures systems, tools, and support processes required for vendor operations are functioning effectively.
• Encourages a culture of accountability, continuous improvement, and partnership with the offshore vendor.
• Performs all other appropriate responsibilities and duties as assigned.