TataAIG - Specialist/Manager - Provider Management
3 days ago
About the Role:We are seeking a highly skilled and detail-oriented Provider Management Specialist/Manager to lead and optimize our provider lifecycle operations. This role will be responsible for overseeing provider onboarding, credentialing, contracting, data management, and performance monitoring, ensuring operational excellence and compliance. The ideal candidate will bring strong analytical skills, cross-functional collaboration experience, and a proven ability to drive provider engagement and efficiency.Key Lifecycle Management: Manage end-to-end provider onboarding, credentialing, contracting, and termination processes with precision and efficiency.Data Integrity & Compliance: Maintain accurate and up-to-date provider data in internal systems while ensuring compliance with all regulatory, contractual, and organizational requirements.Performance Monitoring: Track, analyze, and report provider performance metrics; proactively identify gaps and implement corrective actions to enhance provider outcomes.Issue Resolution: Act as the escalation point for provider-related issues, ensuring timely resolution and clear communication.Cross-Functional Collaboration: Partner with operations, compliance, legal, and technology teams to streamline workflows, eliminate bottlenecks, and enhance provider experience.Network Expansion & Engagement: Support initiatives to expand provider networks, strengthen relationships, and increase provider participation in organizational programs.Data-Driven Insights: Conduct analysis of provider data to uncover trends, risks, and opportunities for continuous improvement and strategic decision-making.Qualifications & ExperienceEducation: Bachelor's degree in Healthcare Administration, Business Management, or a related field (Master's degree Minimum 3+ years of experience in Provider Management within healthcare, insurance, or a similar regulated environment.- Strong understanding of provider contracting, credentialing, and regulatory compliance.- Proficiency in provider data systems, reporting tools, and workflow management platforms.- Demonstrated ability to manage complex stakeholder relationships and drive cross-functional initiatives.- Excellent problem-solving, communication, and organizational skills. (ref:iimjobs.com)
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