Provider Management/Healthcare Purchasing

Management Profile: Provider Management/Healthcare Purchasing

Roles & Responsibilities:

• Tariff Negotiations and cost management
• Conducting surprise audits and checks of the claims and case to case negotiations
• Manage workload of both field and office effectively
• Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics)
• Understanding of Health Claims and claim related processes
• Good understanding of Health Insurance and related products
• Managing relationship with the providers
• Flexible to travel across locations based on the organizational requirements
• Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates)
• Managing and controlling of cost for the portfolio assigned
• Timely reporting of business MIS and reports to leadership team
• Analytical and data-driven approach in day to day work
• Lead and manage the technology & process related initiatives
• Complying to the audit and compliance related concerns as per organization guidelines
• Ability to collaborate with various cross functional stakeholders and drive the agenda for closure
• Should have a good analytical mind to understand costs associated with hospital tariffs and claim cost and manage them effectively.
• Should have excellent communication, presentation and detailed oriented skills (MS Excel, PowerPoint)

Required Qualification / Experience

• MBBS/B Pharma /M-Pharma/Physiotherapy/BAMS/BHMS/Paramedics or similar prior experience as per above roles and responsibilities
• High on energy, innovative thinking, passionate and can do attitude.
• Firm believer of fostering relationship at all level to achieve business objectives.
• Good Communication & Negotiation skills
• Good Excel Knowledge
• Proficiency in speaking Telugu language is a must as he would be managing AP & Telangana location where Telugu is a must.