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Hiring Multiple SMEs for Core Insurance Transformation (IRDAI Expertise Required) Location: Remote (with occasional visits to Munich) We are seeking multiple Subject Matter Experts (SMEs) to support a major core health insurance platform transformation program . All roles require solid knowledge of IRDAI regulations , strong process design capabilities, and the ability to translate business logic into detailed system requirements for IT teams. Work is primarily remote , with periodic on-site workshops in Munich . Open SME Roles: Provider Management (SC02328) Design and streamline provider lifecycle processes (empanelment, contracting, tariffs, delisting), approval flows, data models, and integrations with claims, fraud, and finance. Strong IRDAI knowledge on provider norms is mandatory. Sales, Onboarding & Commission Management Define onboarding workflows, sales hierarchy, commission rules, compliance controls, and integration with CRM/finance. Requires familiarity with IRDAI solicitation guidelines and experience with CRM/commission systems. Underwriting & Medical Underwriting Map underwriting journeys, build rule sets, decision matrices, reinsurance triggers, and ensure alignment with IRDAI product approvals. Experience with rule engines and digital underwriting tools is preferred. Claims Management & TPA Interface Design end-to-end claims workflows (cashless & reimbursement), workload balancing rules, TPA API/EDI interfaces, escalation paths, and fraud triggers. Must have strong understanding of IRDAI claims regulations and SLA requirements. Policy Administration Define processes for issuance, renewal, upgrades/downgrades, endorsements, cancellations, and premium logic. Ensure compliance with IRDAI circulars and validate integrations with finance and customer-facing modules. Reporting & Regulatory Define IRDAI reporting frameworks, data models, mapping logic, and MIS dashboards. Lead automation of statutory filings and ensure accuracy of operational-to-financial reconciliations. Strong BI/SQL/data governance expertise required. What We’re Looking For: 4–5 years SME experience in the respective domain (10–15 years for Reporting SME). Strong capability in as-is/to-be process design , workflow modelling, and gap analysis. Proven experience translating business logic into IT/system requirements. Background working with core insurance platforms , system configuration, and UAT. In-depth understanding of IRDAI regulations relevant to the domain. Ideal Backgrounds: Healthcare administration, insurance operations, business analysis, medical underwriting, MIS/regulatory reporting, or hands-on involvement in system transformation programs (Guidewire, TCS BaNCS, Premia, LifAsia, etc.).