TPA - Health Insurance Manager

Key Responsibilities:

TPA & Insurance Networking

• Build and maintain relationships with TPAs, insurance companies, and corporate health clients.
• Ensure diagnostic centre is empanelled with major TPAs and insurers.
• Act as a liaison between the diagnostic lab and insurance companies for service coordination.

Sales & Revenue Growth:

• Drive revenue through insurance-related health check-ups, cashless diagnostic services, and wellness packages.
• Identify opportunities to increase patient volume through insurance-tied programs.
• Develop new business from TPAs and corporate clients.

Empanelment & Contract Management:

• Ensure timely renewal and compliance of contracts with insurance companies and TPAs.
• Handle documentation for empanelment and assist in negotiation of service rates.

Operations Coordination:

• Coordinate with internal teams to ensure smooth patient processing for insured customers.
• Monitor billing, claim submissions, and dispute resolutions with TPAs.

Client Servicing:

• Manage service-level expectations with TPAs and clients.
• Address queries and complaints related to insurance processes or coverage.

Target Achievement:

• Meet monthly/quarterly sales targets from TPA and insurance channel.
• Monitor and report key performance metrics (e.g., number of empanelled insurers, TPA-driven footfall).

Awareness & Promotion:

• Conduct sessions/workshops with TPAs or HR teams of corporates to promote diagnostic services.
• Assist marketing team in promoting health packages tailored for insured customers.

Compliance & Reporting:

• Ensure adherence to IRDAI regulations and internal policies.
• Maintain MIS reports related to insurance billing, TPA revenue, and client performance.

Qualifications:

1. Bachelor's degree in any discipline (MBA Sales & Marketing)

2. Insurance industry experience (TPA, health insurance, or related field) preferred

3. Understanding of life insurance regulations (IRDAI) and TPA operations

Skills:

1. Experience in the healthcare or insurance industry

2. Knowledge of diagnostic services and TPA operations

3. Strong communication and relationship-building skills

4. Sales and business development skills

5. Negotiation and contract management skills

6. Analytical and problem-solving skills

7. Ability to work independently and manage multiple stakeholders

8. Knowledge of diagnostic services and healthcare industry

Role & responsibilities