2683 Claims Examiner 2 Managed Care jobs near me

Req ID#: 416675

Hyderabad, India, IN

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Job Description:
About Foundever

Foundever is one of the world’s leading customer experience (CX) companies, delivering outsourced sales, technical support, customer service, and other business processes for many of the world’s largest brands. Foundever securely connects brands with their customers millions of times each day in more than 60 languages, supported by approximately 150,000 associates across 45 delivery countries.

Job Summary

Owns the operational governance layer between the enterprise and its IT service vendors — carriers, data centre and colocation providers, managed service partners and infrastructure suppliers.Two connected mandates:

• Governance — hold vendors to the SLA and KPI commitments in the VMO framework, and produce the evidence base behind scorecards, business reviews and escalations.
• RFO (Reason For Outage) — own the end-to-end RFO lifecycle for every P1/P2 incident with vendor involvement: raise, chase, quality-review, challenge, close, and drive the corrective actions.

This is a hands-on analytical role, not a coordination role. The holder is expected to interrogate vendor data independently and hold a supplier to its contract with evidence rather than assertion.

Primary Job Responsibilities

Vendor Governance & SLA Compliance

• Maintain the vendor SLA and KPI registers across the Telecom, Network, Systems — definitions, formulas, data sources and reporting cadence.
• Validate vendor-reported availability, MTTR and SLA attainment against internal incident and monitoring data; reconcile discrepancies and formally challenge overstated performance.
• Publish monthly vendor scorecards with RAG posture, trend analysis and breach summaries; run monthly service reviews and quarterly business reviews end to end.
• Track vendor improvement plans to closure, escalating stalled items through the agreed escalation matrix.

RFO Lifecycle

• Raise RFO requests within the contracted window for every qualifying P1/P2 incident; maintain a live tracker of request date, due date, ageing, owner and closure evidence, and report overdue items weekly.
• Quality-review every submission against a defined acceptance standard — confirmed root cause (not a symptom), accurate timeline, corrective and preventive actions with named owners and dates. Reject and re-issue submissions that fall short.
• Correlate RFOs across time, vendor and site to expose chronic causes and repeat failure patterns; feed confirmed root causes into problem management and the change process.
• Identify SLA breaches evidenced by RFOs and initiate service credit or penalty claims with Procurement and Finance.

Contract, Commercial & Reporting

• Maintain the contract repository and a renewal calendar with lead-time triggers — MSAs, SOWs, SLA schedules, notice periods, termination liabilities and price books — so nothing auto-renews without commercial review.
• Perform contract-to-invoice validation; recover billing errors, ghost circuits and services billed after disconnection.
• Support sourcing events (RFI/RFP/RFQ) and renewal negotiations with evaluation matrices and gap analysis against agreed contractual positions.
• Own the Circuit & Vendor and vendor SLA content in the daily, weekly and monthly IT Operations reporting pipeline and the MBR, under strict no-fabrication data discipline — every figure traceable to a named source.

Risk & Compliance

• Maintain vendor risk records covering concentration risk, single points of failure and security posture; support internal and external audit evidence requests.
• Keep governance artefacts aligned to ITIL 4, ISO 20000, ISO 27001, SOC 2 and PCI DSS control expectations as applicable.

Experience & Qualifications

Essential

• 7–10 years in vendor management, IT service management, telecom/network operations governance or IT procurement analytics — at least 3 years in a governance, SLA or supplier performance role.
• Demonstrable ownership of an RFO/RCA process with carriers or managed service providers, including rejecting substandard root cause analysis.
• Working knowledge of MPLS, SD-WAN, internet circuits, SIP/voice, data centre and managed security services — enough to read an outage report critically.
• Strong command of SLA constructs: availability calculations, MTTR/MTTD, service credit regimes, exclusions, maintenance windows and measurement disputes.
• Advanced Excel (pivots, lookups, multi-tab analytical workbooks) and ITSM tooling — ServiceNow, Remedy or Jira Service Management — for incident, problem and change data.
• Writes cleanly for a senior audience: concise summaries, defensible escalation notes, usable minutes. Bachelor's degree in Engineering, IT, Business, Supply Chain or related.

Preferred

• Contract review and negotiation support — SLA schedules, termination and early termination fees, change control, renewal terms.
• ITIL v4 (strongly preferred), CIPS/CPSM, Six Sigma Green Belt, PMP or PRINCE2. Power BI, or Python/openpyxl for reporting automation.

What We Offer

Impactful work. Opportunity to work on cutting-edge AI technologies that will be game-changers for our business.
Professional growth. Continuous learning and development opportunities in a dynamic, remote work environment.
Competitive compensation. Attractive salary and benefits package.
Collaborative environment. A supportive team culture with opportunities for occasional travel for training and industry events.

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