Provider Network Business Systems Implementation Specialist

16 hours ago

Mumbai, Maharashtra, India beBeeImplementation Full time ₹ 96,00,000 - ₹ 1,53,00,000

Job Overview

We are seeking an experienced Business Systems Implementation Specialist to join our team focused on Provider Network Management transformation.

This role is ideal for professionals with a deep understanding of Healthcare Provider Lifecycle Operations and hands-on experience in implementing provider management platforms, particularly within the insurance or TPA domain across the APAC market.

The individual will work closely with cross-functional stakeholders-product, tech, operations, and client teams-to ensure successful implementation and adoption of our next-generation provider management solution.

Main Responsibilities:

  • Lead requirement gathering, gap analysis, and functional design for provider management system implementations.
  • Act as the domain expert on provider onboarding, contracting, credentialing, tariff management, performance monitoring, and compliance workflows.
  • Collaborate with insurer or TPA clients to understand current-state processes and design future-state solutions.
  • Translate business needs into functional requirements, user stories, and workflows in coordination with product and tech teams.
  • Support UAT planning, configuration guidance, and rollout coordination for successful go-lives.
  • Conduct working sessions, discovery workshops, and walkthroughs with APAC-region clients.
  • Identify process improvement opportunities and actively contribute to platform enhancements.

Key Qualifications:

  • Pg/MBA/Be/B.Tech or Equivalent with 5 to 10 years of experience in insurance, TPA, or IT consulting with direct involvement in Healthcare Provider Management System Implementations.
  • Strong understanding of provider lifecycle workflows including onboarding, credentialing, contract & tariff management, and regulatory reporting.
  • Proven experience working with health or life insurance providers in APAC markets, especially with local operational and compliance nuances.
  • Comfortable engaging with cross-functional teams and clients at all levels-business, tech, and operations.
  • Ability to document business requirements clearly and drive solution alignment through workshops and demos.
  • Experience working with or implementing Healthcare Provider Systems.
  • Exposure to claims, pre-authorization, or provider fraud monitoring is a plus.
  • Strong facilitation, communication, and presentation skills.

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