Job Title: Senior Director / Vice President of Operations – Healthcare

Company: Teleperformance (TP)

Program: Healthcare

Location: MOA, Pasay City

Work Setup: 100% Onsite

Work Schedule: US Day Shift (Night Shift – Philippine Time)

Salary Range: ₱250,000–₱350,000 per month

Headcount: 1

Target Start Date: ASAP

Position Overview

Teleperformance is looking for an experienced Senior Director / Vice President of Operations to lead and oversee large-scale Healthcare BPO operations, particularly in Utilization Management (UM), Care Management, and Disease Management.

The successful candidate will be responsible for managing a 500–700 FTE organization, ensuring operational excellence, strong client relationships, financial performance, regulatory compliance, and effective leadership across multiple management levels.

This is a senior executive position requiring extensive healthcare operations experience, hands-on knowledge of U.S. healthcare processes, and a proven track record of managing complex, large-scale BPO operations.

Candidates with an active U.S. Registered Nurse (USRN) license and recent, hands-on Utilization Management experience are highly preferred. However, exceptional non-USRN candidates with strong healthcare domain expertise and senior operational leadership experience will also be considered.

Key Responsibilities

1. Strategic and Operational Leadership

- Lead and oversee overall healthcare operations, ensuring achievement of client expectations, KPIs, SLAs, productivity, and quality targets.

- Develop and implement operational strategies aligned with business objectives.

- Manage large, multi-layered leadership teams, including Directors, Senior Managers, and Operations Managers.

- Ensure operational stability, efficiency, and business growth across healthcare programs.

2. Healthcare Operations Management

- Oversee Utilization Management, Care Management, and Disease Management operations.

- Ensure effective management of Prior Authorization, Prospective, Concurrent, and Retrospective Reviews.

- Oversee Appeals and Grievance operations, Clinical Reviews, and Medical Necessity processes.

- Maintain quality, productivity, accuracy, and turnaround time standards.

- Ensure compliance with U.S. healthcare guidelines and operational requirements.

3. Client and Stakeholder Management

- Build and maintain strong relationships with senior-level healthcare clients.

- Lead business reviews, governance meetings, and Quarterly Business Reviews (QBRs).

- Identify operational challenges and implement performance improvement strategies.

- Work closely with Sales, Solutions, and Transition teams for new program launches and business expansion.

4. Financial and Business Management

- Oversee operational budgets, costs, revenue, and profit margins.

- Develop strategies to improve operational efficiency and financial performance.

- Manage workforce planning, staffing efficiency, productivity, and attrition.

- Ensure cost-effective operations without compromising quality and compliance.

5. Compliance and Risk Management

- Ensure compliance with HIPAA, PHI protection, and applicable U.S. healthcare regulations.

- Maintain audit readiness and effective internal controls.

- Work with Quality and Compliance teams to address audit findings and implement corrective actions.

- Identify and minimize operational and regulatory risks.

6. People Leadership and Development

- Lead and develop a 500–700 FTE organization.

- Mentor and guide senior leadership teams and operational managers.

- Build leadership capabilities and succession plans.

- Promote employee engagement, accountability, retention, and high performance.

7. Process Improvement and Transformation

- Identify opportunities to improve operational efficiency, quality, and productivity.

- Use performance data and analytics to support business decisions.

- Drive process standardization, automation, digitization, and continuous improvement initiatives.

Qualifications and Requirements

Required Qualifications:

- At least 10 years of Healthcare Operations experience in a BPO, shared services, or captive environment.

- At least 5 years of senior leadership experience at Director, Senior Director, VP, AVP, or equivalent level.

- Proven experience managing 500 or more FTEs in a large-scale, multi-layered operation.

- Recent, hands-on experience in at least one or more of the following:

  - Utilization Management (UM) – strongly preferred.

  - Care Management.

  - Disease Management.

- Strong understanding of U.S. healthcare processes, clinical workflows, and medical terminology.

- Knowledge of MCG/Milliman, InterQual, CMS guidelines, and HIPAA.

- Proven experience in executive client management, operational performance, and business optimization.

- Experience in budgeting, forecasting, workforce management, and financial performance.

- Strong leadership, communication, analytical, and decision-making skills.

- Bachelor's degree in Nursing, Healthcare Administration, Business Administration, or a related field.

Preferred Qualifications:

- Master's degree or MBA.

- Active U.S. Registered Nurse (USRN) license.

- Recent, hands-on Utilization Management experience.

- Experience handling Prior Authorization, Clinical Reviews, and Medical Necessity processes.

- Strong combination of clinical healthcare knowledge and large-scale BPO leadership experience.

Important: General BPO leadership experience without direct healthcare operations and domain expertise will not meet the requirements for this position.

Additional Advantages

The following qualifications are beneficial but not mandatory:

- Exposure to Medical Coding operations, including ICD-10, CPT, and HCC.

- Lean Six Sigma or Process Excellence certification.

- Experience managing multiple healthcare programs or accounts.

- Additional clinical or healthcare-related certifications.

Medical Coding experience is an added advantage and is not a mandatory requirement.

Target Candidate Backgrounds

Candidates with experience in the following organizations and healthcare environments are encouraged to apply:

- Shearwater Health

- Optum

- HGS

- EXL

- Sagility

- Blue Cross Blue Shield organizations

- UnitedHealthcare

- Elevance Health

- Aetna / CVS Health

- Cigna / Evernorth

- Humana

- Centene

- Molina Healthcare

Relevant Target Job Titles:

- Senior Director of Healthcare Operations

- Vice President of Healthcare Operations

- Director of Operations – Healthcare

- AVP of Operations – Healthcare

- Director of Clinical Operations

- Director of Utilization Management

- Head of Utilization Management

- Director of Care Management

- Senior Operations Director – Healthcare

Important Hiring Restrictions

Candidates with previous employment at any of the following companies are strictly ineligible for rehire, whether directly or through a third-party provider:

- Teleperformance (TP)

- PSG Global

- Majorel

- Aegis

Applicants must have a complete and verifiable employment history. Candidates with previous employment at any of the restricted organizations cannot proceed with the application.

Recruitment Process

Qualified candidates will go through the following recruitment stages:

1. CV Review and Validation

2. Initial Phone Interview

3. Talent Acquisition (TA) Interview

4. Three Interview Rounds, with the final interview conducted face-to-face at EDSA or McKinley.

Compensation

Monthly Salary Range: ₱250,000–₱350,000

The final compensation package will depend on the candidate's current or previous salary, relevant experience, qualifications, and overall suitability for the position. Salary expectations must be reasonable and within the client's approved budget.

Ideal Candidate Profile

The ideal candidate is a highly experienced healthcare operations executive with the ability to take complete ownership of a 500–700 FTE organization.

Candidates with a combination of senior-level BPO leadership, strong U.S. healthcare domain knowledge, and recent hands-on Utilization Management experience will receive priority consideration.

An active USRN license is a significant advantage, but exceptional non-USRN healthcare operations leaders are also welcome to be considered if they meet the core requirements.

Interested and qualified candidates are encouraged to apply.