Sr Director Claims Operations

We are SAGILITY

At Sagility we are redefining the future of healthcare operations through technology transformation and talent. As the largest pure-play healthcare BPM provider we deliver end-to-end front and back-office solutions backed by 25 years of domain expertise. With a people-first philosophy we deliver AI-powered high-quality and patient-centric services. Our services span five core healthcare practicesClaims Engagement Services Payment Integrity Clinical UM/CM and Provider Network Operationspowered by proprietary platforms like BirchAI and Provider Forward. We support our clients; payers providers and their partners including 6 of the top U.S. health plans. Our global operations span India Philippines Jamaica Colombia and the U.S processing 119 M claims and managing 78 M customer interactions annually.

Our Scale & Imapact

Company overview

About Sagility

In November 2024 Sagility India Limited was listed on the National Stock Exchange of India (NSE) and Bombay Stock Exchange (BSE). With this milestone our resolve to create value and remain an employer of choice is stronger than ever.

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Strategic acquisitions like Devlin Consulting (analytics-led Payment Integrity) BirchAI (Gen AI-driven communication) and BroadPath (telehealth and remote services) have bolstered our delivery capabilities and expanded our clinical footprint in the U.S. With deep roots in India and other delivery locations and a fast-expanding onshore presence in the U.S. Sagility operates as a cross-border transformation engine built for scale speed and care. We are positioned in the Leaders Quadrant in Payer Operations by Everest Group and recognized as a Leader in Generative AI Services in the ISG Provider Lens.

Growth at Sagility is built into our DNA. We enable career advancement through AI-powered training paths structured mentorship and cross-border opportunities. We drive digital healthcare transformation through modular cloud-native offerings such as BPaaS Contact Center-as-a-Service UM automation Digital Mailroom and Analytics-as-a-Service helping clients reduce costs modernize workflows and deliver value-based care. Our acquisition of BroadPath adds onshore scale and seasoned healthcare talent to deliver U.S.-based tech-enabled services at speed and scale. With 34 delivery centers and offices multilingual capabilities and regulated setups our operations are as agile as they are scalable.

Our culture is built on empowerment inclusion and sustainability. 62% of our workforce are women and we champion opportunity and accessibility for allincluding Persons with Disabilities (PwD). Giving back to the communities we serve is at the heart of who we are. Over 56% of our employees participate in volunteer initiatives collectively impacting 43000 lives annually through social impact causes like education healthcare access and livelihood improvement.

We are also advancing environmental responsibility by sourcing 25% of our energy from renewables and deploying 30 electric vehicles to reduce emissions. Sagility’s near-term greenhouse gas (GHG) emission reduction targets have been officially validated by the Science Based Targets initiative (SBTi) reaffirming its commitment to the 1.5°C pathway. Recognitions like LinkedIn’s Top 15 Workplaces to Grow a Career’ (Philippines) and Best Employer for Women (Economic Times India) affirm our belief that strong values drive strong performance. Joining Sagility means becoming part of a dynamic technology-first ecosystem where your expertise drives real-world transformation. With cutting-edge platforms Gen AI-powered automation and career pathways built on frontline leadership growth we equip every team member with the tools mentorship and global environment to thrive.

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Job Description Sr Director - Claims Operations

Grade: US2 Location: Bangalore IND Reports to: AVP

Job summary

For Senior Director an ideal candidature would be 18 years overall experience with min 10 years in us healthcare payer operations.

Duties and responsibilities

Identifying Transformational Value Creation via RPA and Analytics offerings. Value additions and Process Improvement Initiatives. Account Management Program/ Business Budget and Supply Planning P&L Management (Revenue management Cost Optimization Improvements) Service Quality Management Client Communications Management Provide strategic direction to assigned lines of businesses Take leadership role in migration to new case management database. Stakeholder Management Statutory Audit & Compliance Adherence (HIPAA/ISO/ISMS). Track program performance and its impact on the financial goal Creating Growth Path/Succession Planning for the process Effective Resource Utilization Define and review KRA of Deputy Manager Manager Senior Manager AGM Identify and participate in training / developmental programs. SLA & Metrics Management Responsible for monthly/quarterly/annual performance appraisals of employees in the

vertical. Support development of program policies rules protocols handbooks and forms for all

program components Identify opportunities to streamline business processes and systems. Represent the company and actively participate in operational reviews MBR s/QBRs Timely reporting of deliverables like Performance Incentive Internal Dashboards Identifying recommending and implementing ways to increase the productivity and the

quality of the team. Attend to Process Escalation and provide effective solutions Responsible for Balance Score Card and its parameters Attend to Client calls Stat us Meeting and Client Feedback. Review and Regulate SOP Can identify problems and take decisions independently

Provides solutions to individual and organizational challenges. Delivering Highest Level of Service Delivery Standards Exemplify Passion for excellence. Design and Drive Business/Program Excellence Initiatives Voice of the Organization Inspirational Leadership Lead from the front as the SME of the Business/ Program Design & Drive People Metrics Promoting Diversity & Inclusion as per Organisational Culture Mentoring & Coaching Operational & Leadership values Improve employee retention and enhance employee engagement. Succession Planning

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Skills & competencies

Must be working with U.S based Business / Customers in U.S Shifts Statutory Audit & Compliance Adherence (HIPAA/ISO/ISMS) Minimum 10 years of work experience in end to end Claims Adjudication domain Business Excellence/ Improvements Projects Managed a large and Complex Delivery Team Minimum Span Management should be 300 FTE. Client & Stakeholder Management P&L Management Preferable Onshore Transition experience Coaching and Mentoring Excellent Communication Skills Excellent Analytical skills Excellent People Management Excellent Presentation Skills

Minimum education and experience required

A Bachelor degree or equivalent qualification. RPA/ Analytics Certification preferred Preferably Lean/ Six Sigma Certified Ideal candidature would be 18 YEARS OVERALL EXPERIENCE WITH MIN 7- 10

YEARS IN US healthcare Payer Operations

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