Senior Director / VP of Healthcare Operations Healthcare BPO Operations & Utilization Management Philippine Night Shift

Job title : Senior Director / VP - Healthcare BPO operations & utilization management

Location: MOA, Pasay City, Philippines
Experience: 10 - 15yrs
Work Setup: Onsite
Shift: US Day Shift (Philippine night shift)

Job Description : 

We are hiring an experienced Senior Director / Vice President of Operations to lead large-scale healthcare BPO operations with a focus on Utilization Management (UM), Care Management and Disease Management. The role involves managing 500–700 FTEs, driving operational excellence, ensuring regulatory compliance and maintaining strong client relationships and financial performance.

Key Responsibilities : 

• Lead and manage large-scale healthcare operations and senior leadership teams.

• Oversee Utilization Management, Care Management and Disease Management processes.

• Manage Prior Authorization, Clinical Reviews, Appeals and Medical Necessity workflows.

• Ensure achievement of operational KPIs, SLAs, quality and productivity targets.

• Build and maintain executive-level client relationships and lead governance reviews.

• Manage operational budgets, staffing, costs, margins and P&L performance.

• Ensure HIPAA-aligned compliance, data privacy and audit readiness.

• Develop leadership teams, succession plans and employee engagement initiatives.

• Drive process improvements, automation and operational transformation.

Required Skills : 

• Healthcare BPO Operations Leadership

• Utilization Management / Care Management

• Large-Scale Operations Management

• Client & Stakeholder Management

• P&L and Financial Management

Qualifications : 

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

• Master's degree/MBA preferred.

• 10+ years of healthcare operations experience.

• 5+ years in senior leadership positions.

• Recent hands-on experience in UM, Care Management or Disease Management.