Claims Operations Supervisor

Supervisor, Operations - Offshore Vendor Oversight
The Supervisor, Operations - Offshore Vendor Oversight is responsible for the day-to-day operational management, performance oversight, and quality assurance of an offshore claims processing vendor supporting Independence Claims Operations. This role ensures all vendor-managed functions are completed accurately, timely, professionally, and in compliance with contractual obligations, regulatory requirements, and departmental standards. Serving as the primary operational liaison between Independence and offshore vendor partners, this individual provides leadership, guidance, escalation management, and continuous improvement oversight to ensure service levels, operational goals, and customer experience expectations are consistently achieved.
Key Responsibilities

• Provide operational oversight and governance for offshore vendor claims processing activities.
• Ensure vendor compliance with contractual service level agreements (SLAs), key performance indicators (KPIs), quality standards, and regulatory requirements.
• Monitor and analyze daily, weekly, and monthly vendor performance metrics, including productivity, accuracy, turnaround times, and quality outcomes.
• Assess operational effectiveness and workflow efficiency, partnering with vendor leadership to optimize staffing, resource allocation, and processes as needed.
• Serve as the primary point of contact for operational issues, escalations, and resolution of vendor-related concerns.
• Collaborate with internal stakeholders including Claims Operations, Quality, Compliance, IT, Finance, and Vendor Management to coordinate activities and resolve operational issues.
• Communicate, interpret, and enforce corporate and departmental policies, procedures, and process updates with offshore vendor partners.
• Lead root cause analysis for operational errors, defects, or service failures, ensuring corrective action plans are implemented and sustained.
• Support the implementation of new initiatives, system enhancements, and operational process changes impacting vendor operations.
• Review and validate vendor training plans to ensure staff are adequately trained on claims processing procedures, systems, and Independence requirements.
• Provide ongoing coaching and performance feedback to vendor leadership to drive continuous improvement and operational excellence.
• Ensure all inquiries, follow-ups, and escalations handled by the vendor are resolved professionally, accurately, timely, and courteously.
• Compile, analyze, and present operational reports related to vendor performance, trends, risks, and improvement opportunities.
• Maintain departmental standards that support an optimal customer and provider experience.
• Ensure operational systems, tools, and support processes required for vendor performance are functioning effectively.
• Foster a culture of accountability, collaboration, partnership, and continuous improvement with offshore vendor teams.
• Perform additional duties and responsibilities as assigned.

Required Qualifications

• Minimum of five (5) years of experience in insurance operations, including demonstrated experience in claims processing.
• Strong understanding of operational oversight, quality management, and performance monitoring within a high-volume environment.
• Proven ability to analyze operational data, identify trends, and implement corrective actions and process improvements.
• Strong vendor management and relationship management skills with the ability to influence and drive results without direct authority.
• Excellent organizational, planning, and time management skills with the ability to manage competing priorities in a fast-paced environment.
• Strong verbal and written communication skills, including the ability to clearly communicate expectations, feedback, and performance outcomes.
• Demonstrated ability to manage sensitive operational, quality, and performance-related issues with professionalism, tact, and diplomacy.
• Ability to work independently with minimal supervision while maintaining accountability for results.
• Ability to adapt quickly to changing operational priorities and business needs.

Preferred Qualifications

• Prior experience overseeing offshore or third-party vendor operations strongly preferred.
• Experience in high-volume claims processing operations preferred.
• Knowledge of local and BlueCard claims processing business, processes, and applications preferred.
• HealthRules experience preferred.

#LI-VA1