Senior Manager

Role & 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

Preferred candidate profile

We are looking for a doctor profile with relevant experience in claims and willing to travel across AP & Telangana states.

• 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)