Job Description

Team Manager – Healthcare / Insurance Operations

Location: Philippines

Shift: Night Shift (US Hours)

Work Setup: [Onsite / Hybrid / Remote – as applicable]

Job Summary

We are looking for an experienced Team Manager with a strong background in U.S. Healthcare or Health Insurance Operations to lead high-performing teams supporting healthcare processes. The ideal candidate has proven people management experience, drives operational excellence, and consistently delivers results across quality, productivity, SLA, and customer satisfaction metrics.

Job Requirements

Current or previous Team Manager, Supervisor, or Team Leader experience.

Direct people management.

Healthcare or Health Insurance operations background.

Experience managing 15+ FTEs.

Hands-on exposure to healthcare processes (Claims, Prior Authorization, Benefits, Eligibility, Provider/Member Services, Medical Billing, or Revenue Cycle).

Responsibilities

Manage the day-to-day operations of a healthcare or health insurance team.

Lead, coach, mentor, and develop a team of 15–25+ employees.

Conduct regular coaching sessions, performance reviews, and career development discussions.

Monitor and improve KPIs including:

Productivity
SLA
Quality
CSAT
AHT
Attendance

Handle escalations from members, providers, and internal stakeholders.

Analyze operational metrics and identify process improvement opportunities.

Partner with QA, Training, Workforce Management, and Operations leadership to drive performance.

Ensure compliance with HIPAA, company policies, and client requirements.

Prepare operational reports and present business updates to senior leadership.

Drive employee engagement, retention, and succession planning.

REQUIRED QUALIFICATIONS:

Bachelor's degree preferred.
At least 2–3 years of experience as a Team Manager, Supervisor, or Team Leader in a BPO or Shared Services environment.
Minimum 5 years of U.S. Healthcare or Health Insurance Operations experience.
Proven experience managing a team of 15 or more employees.
Strong experience in one or more of the following:
Medical Claims Processing
Prior Authorization
Benefits Verification
Eligibility
Provider Services
Member Services
Revenue Cycle Management
Medical Billing
Denials and Appeals
Experience handling performance management, coaching, disciplinary actions, and employee development.
Strong stakeholder management and communication skills.
Excellent analytical and problem-solving abilities.
Proficient in Microsoft Office applications, particularly Excel.
Preferred Qualifications
Experience supporting accounts such as:
Optum
UnitedHealthcare (UHG)
Carelon
Humana
Aetna
Cigna
Elevance Health
Blue Cross Blue Shield
CVS/Aetna
Knowledge of healthcare regulations and HIPAA.
Lean Six Sigma certification is an advantage.
Experience in process improvement or transformation initiatives.