Director Implementations AR RO

Position Overview

The Process Design SME, will be responsible for designing and setting up the to be processes within the IKS

revenue optimization platform, across new clients & existing client expansions. This is a Process SME function

that aims to enhance Customer CSAT and enable superior business outcomes through successful transition of

Services.

The Process Design SME, will work closely with Customer & other IKS teams (including our sales, Solutions,

technology and delivery team) to develop & execute process workflows and standard operating procedures that

meet our proposed Solution & deliver the Committed Value to our Clients. The Process Design SME is also

expected to work closely with IKS support function organization to create an ecosystem of supporting our growth

in a timely and cost effective manner.

This is a critical function, since each customer engagement may be worth millions of dollars over the contract

term, and success or failure in starting the project right, could lead to huge financial gains or losses, even leading

to termination of contract and loss of our reputation. The position may involve frequent travel to the US, as well as

within India.

Job Description

Understanding the Customer current process, Business context & define IKS way forward processes

• Customize Knowledge transfer questionnaire

• Finalize the Tools / Websites/ accesses etc requirement with client and provide Inputs to IT

• Study Insurance Contracts/ Review analytics, reports and incorporate analysis within process manuals

• Initiate sample accounts analysis for in scope functions

• Review relevant Information (CPTs, Insurances, Payers, Etc.) for the specialty team to add relevant

document (Top payment/denials/appeals)

• Review Client specific guidelines, policies and procedures

Creation, Sign off & Customer Alignment on To Be SOP & Exceptions handling

• Lead all knowledge transfer calls and create SOPs
• Document current workflow practices basis review of accounts, financial analysis and existing process

manual

• Capture Geography Specific Payer Nuances
• Capture Client specific Tribal Knowledge
• Finalize the Tasking Metrics/ Exceptions Grid
• Ensure Execution of the SOPs in Training & Ops

Responsible for baselining & success metrics calibration for their functions

• Share List of Required Reports with the BI Team
• Review output & provide Inputs to BI for finalizing baselining
• Read the BI reports, Identify patterns /opportunities and share their findings with Leadership

Designing, Implementing & Monitoring FMEAs Process & Quality Controls for their function

• Designing, work allocation Strategy
• Create Day to Day work order strategy, post go live
• Review Process Control for the functions and sub functions
• Reviewing Daily Inventory / Outcomes & controls for their respective function for first 90 Days

Reviewing the training Schedule, content and progress of the users

• Review and Approve the assessment on Specialty Nuances for Trainees
• Review & approve Client specific Training content
• Review the trainee Ramp up target
• Review the progress of the Trainees

Governance / Review and update calls with PL/ ADL/BL/ ETC.

Candidate Profile

Essential:

6+ Years of experience in Managing transitions / Operations or as SME for the respective functions. Total of atleast 12-20 years in RCM.

Proven Ability to understand the end to end process and capture Nuance

Unflinching Rigor towards timely and effective execution

Innovative thinking, diagnostic skills, and problem-solving skills

Adept in deployment of risk management & mitigation frameworks.

Ability to work in an entrepreneurial environment with multiple stakeholders across geographies

Strong attention to detail

Assertive personality, skilled in conflict management

Excellent verbal and written communication skills

Strong skills in MS Office and/or Google tools, including PowerPoint / Google Slides and Excel / Google

Sheets

Master's degree in business or healthcare or Project management advanced certifications.

Desirable:

Prior work experience of US healthcare

Prior operating experience.

Process reengineering experience,