
Provider Management/Healthcare Purchasing
2 weeks ago
Management Profile: Provider Management/Healthcare Purchasing
Roles & Responsibilities:
- Tariff Negotiations and cost management
- Conducting surprise audits and checks of the claims and case to case negotiations
- Manage workload of both field and office effectively
- Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics)
- Understanding of Health Claims and claim related processes
- Good understanding of Health Insurance and related products
- Managing relationship with the providers
- Flexible to travel across locations based on the organizational requirements
- Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates)
- Managing and controlling of cost for the portfolio assigned
- Timely reporting of business MIS and reports to leadership team
- Analytical and data-driven approach in day to day work
- Lead and manage the technology & process related initiatives
- Complying to the audit and compliance related concerns as per organization guidelines
- Ability to collaborate with various cross functional stakeholders and drive the agenda for closure
- Should have a good analytical mind to understand costs associated with hospital tariffs and claim cost and manage them effectively.
- Should have excellent communication, presentation and detailed oriented skills (MS Excel, PowerPoint)
Required Qualification / Experience
- MBBS/B Pharma /M-Pharma/Physiotherapy/BAMS/BHMS/Paramedics or similar prior experience as per above roles and responsibilities
- High on energy, innovative thinking, passionate and can do attitude.
- Firm believer of fostering relationship at all level to achieve business objectives.
- Good Communication & Negotiation skills
- Good Excel Knowledge
- Proficiency in speaking Telugu language is a must as he would be managing AP & Telangana location where Telugu is a must.
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