Head of TPA Operations
Management Operation Management Operations Customer Service Insurance
Salary
Location
Benefits
13th month salary
Work-from-home
Flexible working time
Full social insurance
Yearly salary review
Travel/company trips
Laptop/desktop for works
Extra health insurance
Job Overview And Responsibility
- Cross-functional TPA Operations Coordination • Coordinate daily / weekly operations across Claims, Direct Billing, Customer Service, Policy Management and Data Analytics to ensure smooth handover, issue tracking and timely execution. - SLA Monitoring & Follow-up • Track SLA performance by function, identify delays or operational gaps, and follow up with responsible team leaders to ensure corrective actions are implemented. - Issue Tracking & Escalation • Maintain an operations issue log, follow up on pending actions, prepare escalation notes for Deputy GD and support timely resolution of client / insurer / broker feedback. - Process Discipline & Documentation • Support standard operating procedures, workflow clarification, template usage, internal trackers and reporting discipline across TPA Ops teams. - Operational Reporting • Prepare weekly / monthly operations dashboards, including SLA status, ageing cases, pending claims, guarantee letter performance, policy onboarding status, customer service trends and key risks. - Onboarding & Renewal Readiness Support • Coordinate with BDAM, Policy Management, Claims, CS and Direct Billing teams to prepare for new client onboarding, renewal peak periods and handover from insurers/brokers. - Continuous Improvement • Identify recurring pain points, propose practical process improvements, support system enhancement requirements and help monitor implementation. - Stakeholder Coordination • Support operational discussions with internal teams and, where appropriate, join client / insurer / broker meetings for follow-up on service issues and agreed action plans. - Lead / Support TPA Technology Transformation • Drive major TPA digital transformation projects, including system enhancement, AI-assisted claims adjudication, workflow automation and customer journey improvement. • Work closely with BA, in-house Tech, Data Analytics and TPA functional teams to define business requirements, prioritize enhancements, coordinate UAT, support rollout and measure impact on SLA, productivity, claims accuracy and customer experience. - Other tasks assigned by the Company.
Required Skills and Experience
- Bachelor’s degree - Minimum 7–10 years of experience in operations, service delivery, healthcare administration, insurance operations, customer service operations or business process management - Fluent English - Strong Excel / dashboard / reporting capability - Experience coordinating multiple teams or functions - Strong tracking, follow-up, reporting and problem-solving capability - Good understanding of SLA management, process improvement and service operations - Able to work with senior stakeholders and push cross-functional execution without full direct authority - Strong operations and coordination skills - Ability to manage multiple projects and partners - Customer-focused, organized, and detail-oriented - Ability to manage complex projects and multi-task.
Why Candidate should apply this position
- Young and friendly working environment - 13th-month salary - 18 annual leave days - Social insurance, health insurance, and unemployment insurance based on full gross salary - Health care insurance for employees from probation period; after 1 year, the company also covers family members (spouse and children) - Laptop provided for work - Team building activities and annual health check-ups
Preferred skills and experiences
- Experience in healthcare, TPA, insurance, medical network, claims support or employee benefits is preferred
Report to
Deputy General Director
Interview process
- 2 rounds of interviews:• Round 1: Offline with Deputy General Director & Head of HR • Round 2: Online with General Director
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