Provider Network Management

You will be responsible for managing the central operations of the Provider department. Your key responsibilities will include: - Performance Tracking & MIS Management - Tracking Hospital Empanelment Vs. Targets - Tracking Hospital Discount enhancements & packages - Tracking Cashless : Reimbursement Ratio - Tracking ACS improvement - OPD utilization tracking (vendor wise) - Data management and analysis - Managing Queries & Grievances - Publish a Queries & Grievances report every 15 days basis queries received by RMs - Obtain a Queries & Grievances report from TPA every month - Entering comments received from RMs for empanelment requests received and closing cases in time - Compliance & Governance - Ensuring display of updated MCHI Network List on websites - MCHI Hospital Locator Management - Reconciliation of Network list with the ones getting displayed on TPA websites- monthly - SOPs creation and necessary modifications (as per requirements) - Annual review of SOPs Qualifications required for this role include: - Graduation/Post-Graduation - Minimum Experience of 3-5 years, preferably in Provider management (central operations) in Health insurance or General insurance company If there are any additional details about the company in the job description, please provide the same.,