VL BPO is a rapidly growing BPO seeking a career-driven Operations Manager to join our team. The ideal candidate is results-oriented, passionate about building high-performing teams, driving operational excellence, and ensuring exceptional service for our clients
Position Information
Job Title: Operations Manager – Insurance Case Management
Department: Operations
Reports To: Head of Operations / Director of Operations
Location: Remote
Employment Type: Full-Time
Job Summary
The Operations Manager – Insurance Case Management is responsible for leading and overseeing high-volume insurance case management operations in a fast-paced BPO environment. This role ensures the efficient handling of case workflows, achievement of service level agreements (SLAs), and compliance with all regulatory and client requirements.
The Operations Manager will lead Team Leads, Supervisors, and Case Managers while serving as the primary point of contact for client communication and escalations. This role requires a results-driven leader with strong analytical, operational, and client management skills who can independently manage the account and drive continuous improvement.
Work Schedule
Essential Job Functions
(Listed in order of importance with approximate % of time. Total equals 100%.)
# | Function | % of Time |
1 | Operations Management & Oversight – Oversee daily insurance case management operations including authorizations, claims processing, and care coordination to ensure efficiency and accuracy. | 25% |
2 | Team Leadership & Performance Management – Lead Team Leads, Supervisors, and Case Managers; conduct coaching, performance reviews, and corrective actions to drive results. | 20% |
3 | KPI Monitoring & SLA Management – Monitor productivity, accuracy, QA scores, utilization, and turnaround times (TAT) to ensure all SLAs are consistently met. | 15% |
4 | Workforce & Capacity Planning – Manage staffing levels, workflow distribution, and case prioritization to meet client demand and optimize performance. | 10% |
5 | Client Management & Escalations – Act as the primary point of contact for clients; manage escalations, expectations, and maintain strong relationships. | 10% |
6 | Reporting & Business Reviews – Prepare and present operational reports, insights, and lead Weekly/Monthly Business Reviews (WBR/MBR). | 10% |
7 | Compliance & Risk Management – Ensure adherence to HIPAA regulations, data privacy standards, and internal compliance requirements. | 5% |
8 | Process Improvement & Efficiency – Identify operational gaps and implement process improvements to enhance efficiency and service delivery. | 5% |
Required Qualifications (Knowledge, Skills & Experience)
Preferred Qualifications
Work Conditions / Physical Demands / Travel Requirements
This role operates in a fully remote, high-performance environment and requires:
The role involves extended periods of computer use and requires strict adherence to confidentiality, data protection, and compliance standards.
Important Notes
Disclaimer
This job description outlines the general nature and level of work performed and is not an exhaustive list of duties. Responsibilities may be adjusted to meet business needs.
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