Work Preference
Summary
Overview
Work History
Education
Skills
Languages
Hobbies and Interests
ADDRESS
Timeline
Generic
Open To Work

Manu Sanghi

New Delhi

Work Preference

Job Search Status

Open to work
Desired start date: Flexible

Desired Job Title

Associate DirectorTeam Manager– Health and Benefit AdministrationAssistant ManagerLead Quality Analyst

Work Type

Full TimePart Time

Location Preference

On-Site
Location: CanadaAustralia
Open to relocation: Yes

Salary Range

$45000/yr - $200000/yr

Important To Me

Career advancementCompany CultureHealthcare benefits

Summary

Dynamic leader with over 20 years of experience in managing large teams and complex business processes in the insurance sector. Expertise in health and wellness workflows, including payment integrity and claims adjudication. Proven track record in service delivery, process improvements, and client relationship management, achieving high CSAT and NPS scores. Proficient in Microsoft Excel, PowerPoint, and methodologies such as LEAN Six Sigma and process reengineering.

Overview

23
23
years of professional experience

Work History

Associate Director

United Health Group- US MNC
01.2015 - Current
  • Managing complex and critical business of Payment Integrity- Clinical Appeals and Issue Management spanning 320 FTEs consisting of clinical analysts (allied medical professionals), SMEs, front line/service delivery managers/leads handling review of medical records to determine the authenticity of the services billed on suspected fraudulent/claims billed in error.
  • Key responsibilities (current role):
  • Manage Operations (business processes)
  • Operational excellence, business transformation
  • Achieve business MBOs/KPIs/SLAs
  • Handle client, customer complaints/escalations. Perform RCA, brainstorm solutions, implement action, drive control plan and measure the improvement
  • Stakeholder/Client management
  • Team Management, people development
  • Liaising with multiple departments/stakeholders to drive business goals, organizational policies etc.
  • Initiatives like managing engagement budget, part of CSR program etc. at Organization/LOB level
  • Key Accomplishments:
  • Led RPA engagements partnered with technical and functional teams generating 50% reduction in FTE requirements
  • Idea-ted/lead/mentored multiple green belt/lean projects focusing on accuracy improvement, efficiency saves through automation/ elimination of non-value steps, rework, process re engineering etc.
  • Managed multiple process transitions
  • Awarded growth from Deputy Manager to Associate Director
  • Multiple non-operational responsibilities like engagement budget at business level, key responsibilities in CSR group at organizational level etc.

Team Manager– Health and Benefit Administration

Mercer
01.2008 - 01.2015
  • Handled a span of 37 FTE-Analysts, Senior Analysts, SMEs & Assistant Manager
  • Led the operations team and liaised with the training and transitions team in setting up a transition for 8 processes for US clients
  • Handled the entire cycle of Health and Benefits administration from joining till the time employee leaves the organization
  • Administered the changes in health benefit plan due to any change in employee’s life, HR Payroll or Premium
  • Adding dependents and verifying proofs submitted for them.
  • Carrier files processing (Sending updated information to different carriers (Health Insurance Companies regarding any changes in employee’s health plan)
  • Transitioned multiple processes
  • Led process improvement/operational excellence projects

Assistant Manager

Steria (Xansa) India Pvt LTD
01.2006 - 01.2008
  • Handled end-to-end resource allocation supporting the entire cycle of financial services pertaining to Money In/Money Out transactions for Investment products & policies (OEICS, ISA) for one of the leading Insurance and Investment Company in UK (holding of Lloyd’s group).
  • Managed 2 teams comprising of 20 FTEs in total, 2 Subject Matter Experts and additional 22 FTEs as part of TYE project annually.

Lead Quality Analyst

IBM Daksh
01.2003 - 01.2006
  • Worked with claims adjudication department for one of the leading health insurance firms.
  • Worked as a Quality auditor, collaborating with onshore team to ensure consistent and high accuracy.
  • Worked as subject matter expert focusing on error analysis, identification of knowledge gaps and conducting refresher training.

Education

Diploma - Software Technology

Bachelor of Commerce (Hons) - undefined

Maharishi Dayanand University
06.2002

Skills

  • Process optimization
  • Project coordination
  • Stakeholder relations
  • Change management
  • Employee development
  • Lean Six Sigma certified
  • Service-oriented mindset
  • Coaching and mentoring staff
  • Talent acquisition

Languages

English
Full Professional

Hobbies and Interests

Travel, New cuisines, Listening Music, Learning about finance and Equity market

ADDRESS

  • India- GH1 4, Flat #647 Paschim Vihar, New Delhi
  • Canada- 4205 Shipp Drive, Mississauga, ONTARIO L4Z2Y9

Timeline

Associate Director

United Health Group- US MNC
01.2015 - Current

Team Manager– Health and Benefit Administration

Mercer
01.2008 - 01.2015

Assistant Manager

Steria (Xansa) India Pvt LTD
01.2006 - 01.2008

Lead Quality Analyst

IBM Daksh
01.2003 - 01.2006

Diploma - Software Technology

Bachelor of Commerce (Hons) - undefined

Maharishi Dayanand University

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Manu Sanghi