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AVP | Medical Coding Operations | US Healthcare | Pune

COTIVITI

All India, Pune • 1 month ago

Experience: 15 to 19 Yrs

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Job Description

You are currently seeking an AVP Clinical Operations with excellent operational acumen and people management skills. You will be required to communicate with the client (externally) and various departments of Cotiviti (internally) to ensure a high quality of service. Achieving and surpassing service level benchmarks would be a key responsibility. A good understanding of the processes and managing them through frequently occurring changes will be vital for meeting SLAs. Managing resources, their issues, and their career planning is required for the team to continuously improve their performance, which would result in client delight. You will handle a large number of teams with the support of managers, AMs, and team leads. **Relevant Experience and educational requirements:** - Medical qualification- MBBS, BHMS, BAMS, BPT, BDS (Mandatory) - CPC/CIC/CCS certification - Additional relevant certifications would be an added advantage - 15 years of experience in BPO/KPO industry - 5+ years of experience as Senior Manager/Director Operations/ AVP Operations - Experience managing Managers or similar levels - Experience in US healthcare health plan operations (pre-adjudication, post-adjudication, or adjudication) preferred - Implementations/transitions experience preferred **Principal Duties/ Responsibilities:** **Program Management:** - Ensure that the SLAs are met consistently - Identify initiatives and have the Team Leads work on them for improvement of key metrics - Support QIPs to improve efficiency and quality - Present SLAs and associated metrics to reporting manager as well as to the client - Handle various teams in different phases (i.e. implementation, stabilization, BAU) **Client Management:** - Timely, complete, and articulate communication with the client - Highlight issues and propose solutions even before - Escalate to the reporting manager and client engagement team as required **People Management:** - Managing people related issues that are escalated by TLs - Coordinate with department heads for resolution - Career planning of direct reports and guiding TLs in doing so for their teams - Realistic and measurable goal setting - Monitor & control attrition and shrinkage - Create back up for each support role **Initiative:** - Either come up with or identify initiatives that will result in measurable improvement - Constantly monitor these initiatives and guide the team in making it a success **Change Management:** - Manage various types of changes: - Change in process - Expansion due to volume increase - New implementations - Organizational changes e.g. Mergers, accreditation, etc **Attributes and behavior:** - Should not just be a fast learner but also an effective mentor - Have sound knowledge of the program and know where & how to access the finer details - Willingness to work under pressure and stay motivated when there is less to be done - Has credibility with peers and seniors - Have a positive influence on others - Self-motivated driven to achieve results - Have a levelheaded mindset which makes one think that no problem is so big that it cannot be solved and none are too small to be attended to - Passionate about delighting the customer time and again - Good knowledge of general policies and procedures in the industry - Ability to adapt to policies and procedures specific to Cotiviti - Maturity and leadership to manage senior support staff such as managers. - Exhibit behavior consistent with Cotiviti Values - Customer Driven - Collaborative - Accountable - Open You are currently seeking an AVP Clinical Operations with excellent operational acumen and people management skills. You will be required to communicate with the client (externally) and various departments of Cotiviti (internally) to ensure a high quality of service. Achieving and surpassing service level benchmarks would be a key responsibility. A good understanding of the processes and managing them through frequently occurring changes will be vital for meeting SLAs. Managing resources, their issues, and their career planning is required for the team to continuously improve their performance, which would result in client delight. You will handle a large number of teams with the support of managers, AMs, and team leads. **Relevant Experience and educational requirements:** - Medical qualification- MBBS, BHMS, BAMS, BPT, BDS (Mandatory) - CPC/CIC/CCS certification - Additional relevant certifications would be an added advantage - 15 years of experience in BPO/KPO industry - 5+ years of experience as Senior Manager/Director Operations/ AVP Operations - Experience managing Managers or similar levels - Experience in US healthcare health plan operations (pre-adjudication, post-adjudication, or adjudication) preferred - Implementations/transitions experience preferred **Principal Duties/ Responsibilities:** **Program Management:** - Ensure that the SLAs are met consistently - Identify initiatives and have the

Posted on: March 11, 2026

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