Team Manager | AO Clinical Claims

Sutherland
Philippines
Workplace: OnsiteFull timeFunction: Insurance & ActuarialExperience: 3-5 yearsEducation: bachelorsSkills: ["Coaching","Stakeholder management","Analytical skills","Verbal communication","Written communication"]

Lead a team of USRN Clinical Claims Associates/Specialists supporting Accident & Occupational (AO) Clinical Claims operations. Drive operational excellence across productivity, quality, compliance, service levels, and turnaround time while ensuring accurate claims processing and strong customer outcomes. Provide coaching, performance management, and clinical guidance, oversee audits and corrective actions, support client discussions, and deliver continuous workflow and process improvements.

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FursaFursa
Sutherland
Sutherland
1 day ago

Team Manager | AO Clinical Claims

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Last checked: 11 hours agoStatus: Live

Job Summary

Lead a team of USRN Clinical Claims Associates/Specialists supporting Accident & Occupational (AO) Clinical Claims operations. Drive operational excellence across productivity, quality, compliance, service levels, and turnaround time while ensuring accurate claims processing and strong customer outcomes. Provide coaching, performance management, and clinical guidance, oversee audits and corrective actions, support client discussions, and deliver continuous workflow and process improvements.
Location: Philippines
Workplace: Onsite
Employment Type: Full time · Permanent
Job Function: Insurance & Actuarial
Seniority: Manager level

Key Responsibilities

  • •Manage the daily operations of assigned clinical claims teams and ensure targets for productivity, quality, accuracy, compliance, and turnaround time.
  • •Analyze performance trends, implement action plans, and ensure adherence to client processes, policies, and standard operating procedures.
  • •Lead, coach, and develop Clinical Claims Associates/Specialists through performance reviews, coaching, career discussions, attendance management, and engagement/retention initiatives.
  • •Ensure HIPAA, data privacy, client requirements, and regulatory compliance through audits, reviews, and corrective/preventive action plans.
  • •Support client discussions and business reviews, provide team performance updates, participate in calibration and process improvement initiatives, and drive continuous improvement projects.

Key Requirements

  • •Active and unrestricted US Registered Nurse (USRN) license.
  • •Bachelor's Degree in Nursing (BSN) or equivalent nursing qualification.
  • •Minimum 3-5 years of clinical nursing experience in a hospital, healthcare, insurance, disability claims, utilization review, case management, or related setting.
  • •Minimum 2 years of people management experience leading healthcare operations, clinical teams, BPO healthcare accounts, or claims operations.
  • •Strong understanding of medical terminology, clinical documentation, and healthcare processes; excellent verbal and written English communication.
Experience:3-5 yearsHealthcareInsurance
Education:Bachelor's
Skills:CoachingStakeholder managementAnalytical skillsVerbal communicationWritten communication
Licenses:US Registered Nurse (USRN)
Certifications:Lean Six SigmaQualityProcess Improvement
Languages:English

Company Brief

Sutherland
Global digital transformation and business process services firm offering AI, automation, cloud engineering, analytics and customer experience solutions to enterprises across industries.
Industry: Professional Services
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Funding: Private Equity Backed
Headquarters: Pittsford (Rochester), NY, United States
Founded: 1986
Glassdoor
Glassdoor: 3.5
WebsiteLinkedInGlassdoor