Associate Director, Service Quality Capability Development

Service Quality & Capability Development – Healthcare Payer & Services BPO

About Firstsource

Firstsource Solutions Limited, an RP-Sanjiv Goenka Group company, is a global leader providing business process solutions across Healthcare, Banking & Financial Services, Communications, Media & Technology, and Retail. With a global footprint across the US, UK, India, the Philippines, and multiple other geographies, Firstsource partners with Fortune 500 and FTSE 100 clients to deliver transformational BPM solutions.

Job Category

Leadership Function/Department -Service Quality – Capability Development

Reporting to Vice President / Director – Service Quality

Experience: 10–15 years, with 5+ in a quality / capability-development leadership role in healthcare BPO or health plan operations

Qualification: Bachelor's degree (required); MBA / Master's preferred

Work Mode: Work from Office

Location: Taguig

Role Overview

The Associate Director – Service Quality – Capability Development owns the end-to-end quality and capability-development agenda across healthcare payer and services operations. This is a strategic leadership role responsible for defining the service-quality vision, building enterprise-wide QA and training frameworks, driving measurable improvements in operational accuracy and efficiency, and developing the next tier of quality and training leaders. The incumbent partners with Operations, Transitions, Client Services, and Technology teams to translate client requirements and regulatory standards into scalable quality and learning programmes that deliver sustained business outcomes.

Roles & Responsibilities

Strategy & Governance

• Define and own the multi-year service quality and capability development roadmap aligned to the healthcare vertical's business plan, client commitments, and regulatory requirements (CMS, HIPAA, URAC / NCQA where applicable).
• Establish and chair the Quality Governance Council — set standards, scorecards, and review cadences across accounts; present quality performance and improvement plans to senior leadership and client stakeholders.
• Drive enterprise adoption of quality methodologies (Lean, Six Sigma, PDCA) and ensure all improvement initiatives are grounded in data-driven root-cause analysis.

Quality Assurance & Performance

• Design and maintain QA frameworks — audit sampling plans, scoring rubrics, calibration protocols, and corrective-action workflows — across claims, enrollment, PDM, payment integrity, and customer-service processes.
• Analyse quality trends, client feedback, regulatory audit findings, and operational data to identify systemic gaps; sponsor and track targeted improvement programmes to closure.
• Own quality KPIs (accuracy, defect rate, CSAT, first-pass yield) at account and vertical level; ensure timely, accurate reporting to internal and client dashboards.

Capability Development & Training

• Build a scalable training architecture — onboarding curricula, process certifications, refresher programmes, and leadership-development tracks — tailored to healthcare payer operations.
• Introduce blended-learning formats (instructor-led, e-learning, simulations, knowledge assessments) and evaluate effectiveness through pre/post metrics, on-floor application, and business-outcome linkage.
• Partner with Transitions to design Day-1-readiness training for new accounts and process migrations, ensuring TAT and quality SLAs are met from go-live.

Technology & Innovation

• Champion AI-assisted quality monitoring, speech / text analytics, LMS platforms, and automated reporting to scale quality and training operations.
• Collaborate with Technology and Transformation teams to evaluate, pilot, and deploy tools that improve service delivery and customer experience.

People Leadership

• Lead, mentor, and develop a team of quality and capability-development managers and analysts; build succession depth and a high-performance culture.
• Foster strong cross-functional partnerships with Operations, HR, Client Services, and Compliance to drive a unified approach to service excellence.

Key Result Areas (KRAs)

• Quality KPI Achievement — accuracy, defect rate, first-pass yield, and CSAT targets at vertical / account level.
• Training Effectiveness — on-time programme delivery, certification pass rates, new-hire speed-to-proficiency, and training ROI.
• Transition Readiness — 100% adherence to transition-training TAT; zero critical quality escapes in first 90 days post go-live.
• Continuous Improvement — measurable process-improvement savings / efficiency gains delivered through quality initiatives.
• Stakeholder Satisfaction — internal and client stakeholder feedback scores on quality and training partnership.
• People Development — team retention, succession pipeline, and individual development-plan completion.

Qualification & Experience

• Bachelor's degree in any discipline (required). MBA or Master's in Healthcare Administration, Operations Management, or related field preferred.
• 10–15 years of progressive experience in quality, training, or capability development within healthcare BPO, health plan operations, or a managed-care environment, with at least 5 years leading managers.
• Demonstrated track record of designing and scaling quality and training frameworks across multiple accounts or processes.
• Lean Six Sigma Green Belt (required); Black Belt preferred.

Skills & Competencies

Functional / Technical

• Deep understanding of US healthcare payer operations — claims adjudication, enrollment, PDM, payment integrity, customer service — and associated regulatory and compliance requirements.
• Expertise in quality improvement methodologies (Lean, Six Sigma, PDCA, DMAIC) and adult-learning / instructional-design principles.
• Strong analytical acumen — ability to translate data into actionable quality and training insights using Excel, BI tools, and statistical techniques.
• Experience with QMS and LMS platforms; familiarity with AI-assisted quality monitoring and speech / text analytics tools.
• Excellent programme and project management skills; ability to manage concurrent initiatives across geographies and time zones.

Behavioural / Leadership

• Strategic Thinking: Translates business objectives and client needs into a coherent quality and capability-development strategy with clear milestones.
• Influence & Stakeholder Management: Engages and aligns senior leaders, operations heads, and client counterparts; comfortable presenting to C-suite audiences.
• Outcome Orientation: Ties every initiative to a business KPI and tracks through to measurable impact.
• People Development: Builds high-performing teams; invests in coaching managers, creating career paths, and strengthening succession depth.
• Change Leadership: Drives adoption of new processes, tools, and standards across a large, diverse operations footprint with minimal disruption.
• Integrity & Compliance: Models the highest standards of data security, HIPAA compliance, and ethical conduct.

Work Conditions

• Work-from-Office, based out of the Chennai delivery centre; occasional travel to other delivery locations or client sites as required.
• Flexibility to align with US time zones for client calls and cross-site coordination.

Corporate Values

Candidate must demonstrate alignment with Firstsource values – REACCH (Respect, Ethics, Accountability, Customer-first, Collaboration, Higher Purpose).

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