Sr Manager Claims - Provider Management

ROLE AND RESPONSIBILITIES -

v   To execute the strategic network development through new empanelment and renewals.

v   To be responsible for tariff negotiations.

v   Relationship management: To ensure operational efficiency and quality service delivery.

v   Foster effective co ordination and collaboration with internal and external stakeholders to support cross-functional initiatives and process optimization.

v   Fraud & abuse management.

v   Maintaining high quality healthcare standards: Monitor high standards of quality and patient safety within the network hospitals. Ensuring compliance with healthcare quality standards as per IRDAI guidelines.

v   Data analysis: Use data-led analytics to continuously monitor network provider performance, utilization patterns, and patient feedback to generate actionable insights.

v   Regulatory and Management Reporting: Prepare and present performance reports to senior management and key stakeholders like IRDAI.