Job Role: Compliance & Empanelment Lead - Hospital Operations Specialist

About Us:

We are a pioneering organization in the healthcare sector, dedicated to building innovative companies from the ground up. Our mission is to transform cancer care by making world-class treatment more accessible, patient-centric, and closer to home.

Our Vision:

We aim to create a nationwide network of oncology facilities, starting in Delhi and Mumbai, and expanding to 10 cities over the next three years. By doing so, we will eliminate logistical and emotional barriers to cancer care for millions of patients in India.

Key Responsibilities:

The Compliance & Empanelment Lead will play a pivotal role in ensuring all hospital operations comply with regulatory frameworks while driving empanelment with TPAs, insurance providers, and government health schemes. This involves managing licenses, handling empanelment documentation, resolving claim issues, and ensuring smooth recoveries, while also enabling patient acquisition through empanelment channels.

Main Tasks:

• Ensure adherence to all statutory and regulatory requirements applicable to hospitals and oncology centers.
• Manage hospital and clinical licenses, including drug license, pollution control, biomedical waste, fire safety, lift NOCs, and AERB compliance.
• Track and ensure timely renewals of all mandatory approvals and registrations.
• Coordinate with legal advisors, auditors, and regulatory authorities for audits, assessments, and inspections.
• Draft, review, and maintain MoUs, contracts, and other legal documentation.
• Build and maintain compliance dashboards for leadership and insurance management.
• Lead empanelments with TPAs, private insurers, GIPSA, PSU insurers, CGHS, ECHS, ESI, and other government health panels.
• Manage empanelment documentation, application submissions, negotiations, and timely renewals.
• Maintain updated databases of empanelment status, rate contracts, and TPA agreements.
• Resolve empanelment queries, escalations, and support clinic operations teams in leveraging empanelments for patient inflow.

Requirements:

To be successful in this role, you will need:

• In-depth knowledge of hospital compliance frameworks, empanelment procedures, and healthcare regulations.
• Strong understanding of government health panels (CGHS, ECHS, PSU insurers, etc.) and private insurance processes.
• Excellent negotiation, documentation, and stakeholder management skills.
• Proficiency in claim processing, rejections handling, and TPA interactions.
• Ability to coordinate cross-functionally with clinical, finance, legal, and operations teams.
• High attention to detail and ability to thrive in a fast-paced, scaling healthcare environment.

Education:

Bachelors degree is mandatory; LL.B preferred.

Experience:

5-7 years of experience in hospital compliance, empanelment, or liaison roles.

Desirable:

Prior experience in multispecialty hospitals, oncology centers, or TPA/insurance companies highly desirable. Exposure to hospital launches, licensing processes, and empanelment negotiations will be an added advantage.